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SPIRITUALITY AND RESILIENCEASSESSMENT PACKET

MANUALFor Version 4.2

RESOURCES FOR RESILIENCE:

BUILDING A RESILIENT WORLDVIEWTHROUGH

SPIRITUALITY

Behavioral Health Education Initiative Jared D. Kass, Ph.D., LMHC

Lynn Kass, M.A., M.A.T., LMHC Co-Directors

Greenhouse, Inc.46 Pearl Street

Cambridge, Massachusetts 02139 617-492-0050

2000, 1996, 1990, 1989 Jared D. Kass

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TABLE OF CONTENTS

I.        Introduction                                                                                         5

             A.    Purpose of SRA                                                                          5             B.     Description                                                                                 5

II.      History of SRA                                                                                    10

III.    Conceptual Foundations                                                                      12

             A.     Measuring a Resilient Worldview: The IPPA                               12                     1.  Control Dimension: Self Confidence During Stress                  17                     2.  Meaning Dimension: Life Purpose and Satisfaction                  18                     3.  Unifying Concept: Confidence in Life and Self                         19             B.    Measuring Internalized Spirituality: The INSPIRIT                        20                     1.  Religion and Spirituality as Overlapping Concepts                   20                      2.  Characteristics of Internalized Spirituality                                21

IV.    Summary of Research                                                                         23

             A.    Inventory of Positive Psychological Attitudes                                23                     1.   Confirmation of Multidimensional Structure                             23                     2.   Reliability                                                                               25                     3.   Construct Validity                                                                  27                            a.  Correspondence with comparable scales                          27                            b.  Discrimination between populations                                  29                     4.   Outcome Research                                                                30                            a.  Improvements in psychological symptoms and                                 chronic pain                                                                     31                            b.  Improvements in psychological and                                 medical symptoms                                                           32                            c.  Associations with lower levels of                                  health-risk behaviors                                                        33

             B.   Index of Core Spiritual Experiences                                               35                    1.   Confirmation of Unidimensional Structure                                35                    2.   Reliability                                                                                37

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                    3.   Construct Validity                                                                   38                            a.   Correspondence with comparable scales                         38                            b.   Discrimination between population sub-groups                39                    4.   Outcome Research                                                                 41                            a.  The formation of a resilient worldview                              42                            b.   Reductions in health-risk behaviors                                 49                            c.   Reductions in stress-related medical symptoms                53

V.   Normative Data                                                                                      55 

             A.   Conceptual Approach                                                                   55             B.   Data for the IPPA                                                                         57                           1.   Placing the Raw Score in an Interpretive Context              57                            2.  Normative Scores                                                             57             C.   Data for the INSPIRIT                                                                 59                           1.  Placing the Raw Score in an Interpretive Context               59                           2.  Normative Scores                                                             60

VI.   Guidelines for Administration of the SRA                                            64

             A.  Conceptual Approach: Building Collaborative Dialogue                   64             B.  Competency Requirements for Professionals                                   65                           1.  Basic Counseling Skills                                                      65                           2.  Training in Multicultural Competencies                               65             C.  Practical Steps for Preparation                                                        66                           1.  Step One: Take the Test Yourself                                     66                           2.  Step Two: Be Thoroughly Familiar with the Concepts        66                           3.  Step Three: Anticipate Challenging Issues                          67                                  a.  Language to denote “God”                                         67                                  b.   Defining “spirituality”                                                 71                           4.  Formal and Informal Applications                                      78

VII.  Scoring and Interpretation of the SRA                                                 80

TABLES                  1.1   Multidimensional Factor Structure of the IPPA-30                    81                  1.2   Construct Validity of the IPPA                                                 82                  2.1   INSPIRIT Factor Structure                                                     83                  2.2   Experiences of the Spiritual Core and                          Length of Time Meditating                                                       84                  2.3   Relationships Between Internalized Spirituality, Resilience,

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                          and Stress-Related Medical Symptoms Among Outpatients      85                  2.4   Relationships of INSPIRIT to Confidence in Life and                           Self (CLS) and Hostility                                                           86                  2.5   Predictive Model for Cigarette Smoking                                   87

REFERENCES                                                                                                 88

APPENDIX                                                                                                      94

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I.  Introduction

 

A. Purpose

The Spirituality and Resilience Assessment Packet provides clergy, human

service professionals, and educators with a structured vehicle through which they can

engage clients in the development of internal resources that contribute to successful

coping during stressful conditions. This packet enables individuals to examine the

strength of their own psychological resilience, the depth of internalization of their own

spirituality, and the degree to which their spirituality contributes to their psychological

resilience.

B. Description of the Instrument

The Spirituality and Resilience Assessment Packet (SRA) is a multidimensional

self-report instrument. The assessment packet includes two questionnaires. The

Inventory of Positive Psychological Attitudes measures attitudes that characterize a

resilient worldview. The Index of Core Spiritual Experiences measures perceptions and

behaviors that reflect a high degree of internalized spirituality. These questionnaires

can be used separately and together. The Inventory of Positive Psychological Attitudes

can be used, by itself, to assess areas of an individual’s worldview that need to become

more resilient. The Index of Core Spiritual Experiences can be used, by itself, to

assess areas of an individual’s spirituality that may benefit from further examination and

internalization. These questionnaires are used together to assess the degree to which

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internalized spirituality is contributing to a resilient worldview. The questionnaires are

sensitive to cultural differences related to religious background, gender, race, and

ethnicity among United States citizens.

The SRA was developed for use with adults and adolescents with a 6th grade

reading level. It can be administered in written and oral form. Initial administration and

scoring of the SRA requires between 30 and 60 minutes, depending on the reading

proficiency of the individual and the depth of dialogue that evolves between the

individual and the professional administering the assessment process. Subsequent

administration of the SRA, to measure an individual’s growth and development, will

require 20-30 minutes.

The questionnaires that comprise the SRA were developed in two formats, a

research format and a self-test format. In the research format, the items in each

questionnaire are presented in a randomized pattern. In addition, a randomly selected

sub-group of response sets has been assigned reverse ordering of positive directionality

on their Likert scales. The purpose of these randomization procedures is to minimize

socially desirable responses (or perceived socially desirable responses). This format

also maximizes the likelihood that respondents will answer each item carefully, because

the directionality of the “positive” answer varies. This format is scored and interpreted

by the professional who is administering the assessment process. These benefits are

particularly important when conducting research.

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The self-test format is more ideal, however, during psychoeducational

applications of this assessment packet in which the purpose is to engage individuals in

a personal examination of their own resilience and spirituality. In this situation,

individuals often desire, and may require, a maximum degree of privacy and autonomy

during the assessment process. For this reason, the self-test versions of these

questionnaires are structured to enable individuals to score their own tests and to

develop an initial interpretation of their results. In this format, items from each sub-scale

are grouped together for ease of comprehension and interpretation. There is no reverse

ordering of positive dimensions on the instruments’ Likert scales. Instructions for

scoring and initial interpretation are provided to the individual.

The first questionnaire, The Inventory of Positive Psychological Attitudes (IPPA)

measures a resilient worldview, Confidence in Life and Self (CLS). CLS has been

shown to buffer stress and to facilitate the prevention of stress-related psychological

and physical disorders. The IPPA is composed of two related, but distinct, sub-scales.

The first sub-scale, containing 15 items, measures Self-Confidence During Stress

(SCDS). The second sub-scale, containing 17 items, measures Life Purpose and

Satisfaction (LPS). Using a Likert scale ranging from 1-7, individuals report their degree

of agreement with 32 different statements.

The second questionnaire, The Index of Core Spiritual Experiences (INSPIRIT),

measures two elements of spirituality that contribute to the formation of a resilient

worldview. The first element is experiential. It is comprised of personally meaningful

experiences that have convinced an individual that God exists (using the individual’s

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own images and definition of the sacred aspect of life). The second element is

relational. It is comprised of attitudes and behaviors that reflect the perception of a

deeply felt relationship between the individual and the sacred aspect of life. Within this

relational domain, God can be experienced by the individual as “close” and as an “in-

dwelling spiritual core.”

The two aspects of spirituality measured by the INSPIRIT scale can best be

described as “experiences of the spiritual core” or “core spiritual experiences.” Kass

suggests experiences of the spiritual core to be the operant conditions of internalized

spirituality (Kass, 1991a; Kass, 1991b; Kass et al., 2000a).

The INSPIRIT is composed of 7 items. Each item uses a Likert scale ranging

from 1-4. Questions 1-6 contain individual items. Question 7 is a checklist list of 12

spiritual experiences that many people have reported. Likert scales are used in

Question 7 to designate whether or not the individual has had any of these spiritual

experiences, and the impact they have had on the person’s cognitive appraisal

regarding the existence of the sacred aspect of life.

It is important to note that the INSPIRIT scale is not a measure of “spiritual well-

being.” Spiritual well being is a multidimensional and somewhat elusive concept.

Further, it is likely that each major religious tradition would define this construct

somewhat differently. Thus, to suggest that the INSPIRIT taps all dimensions of

spiritual well being would not be accurate. Rather, as an operant measure of

internalized spirituality, the INSPIRIT scale taps an important dimension of spiritual well

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being. Scholarship within the field of Comparative Religions suggests that experiences

of the spiritual core are recognized and valued by each of these traditions (Schuon,

1984). In addition, Fowler’s research in the Psychology of Religion suggests that a

construct like internalized spirituality is related to a mature stage of faith development

(Fowler, 1981). Thus, the INSPIRIT appears to measure an aspect of mature faith

development and an important element of spiritual well being that is shared by our

major religious traditions. In summary, the INSPIRIT scale is best designated as a

measure of internalized spirituality, or as a measure of an aspect of spiritual well-being,

rather than as a comprehensive measure of spiritual well-being.

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II. History of the SRA

Copyrights for the Spirituality and Resilience Assessment Packet, the Inventory

of Positive Psychological Attitudes, and the Index of Core Spiritual Experience are held

by Jared D. Kass, Ph.D.

The conceptual foundations of the IPPA and INSPIRIT, and their original item

pools, were developed by Kass in 1985-1986. Support for this project was provided by

Lesley College through a faculty development grant for research in health psychology

and the psychology of religion.

Validation of the IPPA and the INSPIRIT (factor analytic refinement of the item

pools, measurement of internal reliability, measurement of construct validity, and

preliminary clinical testing) were conducted by Kass from 1987-1990 in collaboration

with Richard Friedman, Ph.D., Jane Leserman, Ph.D., Margaret Caudill, M.D., Ph.D.,

Patricia Zuttermeister, M.A., and Herbert Benson, M.D., at the Division of Behavioral

Medicine, Department of Medicine, New England Deaconess Hospital, Mind/Body

Medical Institute, Harvard Medical School, Boston, MA. Results from these validation

studies were reported in Behavioral Medicine (Kass et al., 1991a) and Journal for the

Scientific Study of Religion (Kass, Friedman, Leserman, Zuttermeister, & Benson,

1991b). Support for this project was provided by Mr. Laurance S. Rockefeller, the

Fetzer Institute, and the United States Public Health Service (HL-27227).

Subsequent to their initial validation studies, the IPPA and the INSPIRIT have

been further refined and tested. The initial format of the IPPA contained 30 items

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(IPPA-30). At that time, the SCDS sub-scale contained 13 questions. To further

strengthen the construct validity of the SCDS sub-scale, Kass added two questions to

this scale. In addition, the wording of 5 other SCDS questions was clarified (IPPA-32R).

The factor structure and reliability of the revised instrument were tested and are

consistent with the factor structure of the IPPA-30 (Kass, 1998b). In addition, the

psychometric properties of the INSPIRIT scale (factor structure, reliability, and construct

validity) received independent verification in a study by VandeCreek (VandeCreek,

Ayres, & Bassham, 1995). Further testing of the factor structure and reliability of the

INSPIRIT have been conducted by Kass and are reported in this manual.

The IPPA and INSPIRIT scales were combined by Kass in 1997 into the

Spirituality and Resilience Assessment Packet, Self-Test Format.

The research versions of the IPPA and the INSPIRIT have been translated into

Spanish. A complete Spanish language version of the SRA will be developed in 2001.

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III. Conceptual Foundations

 

A.  Measuring a Resilient Worldview: The IPPA

 

Psychological assessment has tended to focus on the identification of attitudes

that contribute to, and are symptomatic of, mental and physical disorders. This focus is

most useful when clinicians and researchers seek to identify the degree to which

individuals are impaired or at-risk. This focus becomes less useful, however, when we

seek to identify the nature and strength of attitudes that contribute to resilience and

primary prevention (Antonovsky, 1979).

Since 1975, increased attention has been placed on explaining how resilient

psychological attitudes may contribute to health. This research has focused on the

stress-buffering effects of positive attitudes. Considerable evidence has demonstrated

that frequent activation of the stress response produces chronic hyperarousal through

dysregulation of neurotransmitter functions related to the sympathetic nervous system-

adrenal medulla axis and the hypothalamic-pituitary-adrenal cortex axis of the endocrine

system (Gatchel & Baum, 1983; Rose, 1980). As sequelae to dysregulation of these

systems, individuals develop a range of mental and physical disorders (Gatchel &

Blanchard, 1993). Psychological disorders related to hyperarousal are characterized by

elevated levels of hostility, depression, and/or anxiety (Gold, Goodwin, & Chrousos,

1988a; Gold, Goodwin, & Chrousos, 1988b; Krystal et al., 1989; Van Der Kolk, 1988).

Physical disorders related to hyperarousal are characterized by pathology of the

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cardiovascular, gastrointestinal, immunologic, and neuromuscular systems (Andersen,

Kiecolt-Glaser, & Glaser, 1994; Blascovich & Katkin, 1993; Dorian & Garfinkel, 1987;

Taylor, 1986). In addition, individuals experiencing hyperarousal regularly develop a

range of health-risk behaviors. These behaviors, which may be attempts to regulate the

stress response through forms of self-medication, are leading causes of premature

morbidity and mortality in the United States. They include cigarette smoking, excessive

consumption of high-fat foods, and dependence on alcohol and drugs (Brannon & Feist,

1997; Grunberg & Baum, 1985; Sunderwirth, 1985). It may be useful to note, of course,

that some degree of stress can produce benefits to individuals by contributing to

performance, productivity, the development of new coping skills, and creativity. In

conditions of chronic hyperarousal, however, these benefits are quickly lost.

External stress is universally recognized as an inevitable aspect of life. The

stress response, however, is an internal response to external stress. Thus, the strength

and frequency of an individual’s stress response are not inevitable. Research has

begun to suggest that resilience can function as an intervening variable buffering or

preventing the stress response (Hafen, Frandsen, Karren, & Hooker, 1992; Lazarus &

Folkman, 1984). By contributing to a positive worldview, resilient attitudes help

individuals to be less reactive to, and to cope more successfully with, stressful

circumstances and events. Thus, by helping to regulate autonomic functions, positive

attitudes can help to prevent psychological illnesses, medical illnesses, and health-risk

behaviors.

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Two major constellations of positive attitudinal constructs have been

hypothesized to contribute to resilience and health. The first constellation concerns

locus of control. Using Rotter’s model of internalized versus externalized locus of

control (Rotter, 1966), Langer and Rodin demonstrated that internal locus of control

contributes to health (Langer & Rodin, 1976). Similarly, Seligman has shown that

learned helplessness leads to diminished coping and adaptation (Seligman, 1975).

Wortman and Brehm refined this model by showing that expectations of internal locus of

control counter helplessness (Wortman & Brehm, 1975).

The second constellation concerns perceived meaning. Using Crumbaugh and

Maholick’s operational definition (Crumbaugh, 1968; Crumbaugh & Maholick, 1969;

Crumbaugh & Maholick, 1964), Stevens, Pfost, and Wessel demonstrated that purpose

in life contributes to improved coping (Stevens, Pfost, & Wessels, 1987). Using a

somewhat different operational definition, Reker has shown that life purpose leads to

improved psychological functioning (Reker, Peacock, & Wong, 1987). Additionally,

Abby and Andrews found satisfaction with life to be associated with diminished levels of

depression (Abby & Andrews, 1985).

Initially, investigations regarding the efficacy of these two positive constellations

remained separate. To some extent, the two constellations may have been seen as

competing explanatory hypotheses. Eventually, researchers began to conceptualize

these constellations as complementary, and to measure them within multidimensional

instruments. For example, Kobasa and Maddi developed the concept of “stress-

hardiness” and conceived it as having both control and meaning dimensions (Kobasa,

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Maddi, & Kahn, 1982). Similarly, Antonovsky developed the concept of “sense of

coherence” (Antonovsky, 1987). This construct was also conceived as containing both

control and meaning dimensions.

However, it has become apparent that both the first-generation unidimensional

scales and the second-generation multidimensional scales contain limitations in the

ways that they have conceptualized the control and the meaning dimensions. These

limitations have been articulated from two related perspectives: 1) a multicultural

perspective, and, 2) an existential-religious perspective.

1. Multicultural perspective: Assessment instruments tend to define psychological

health as the attitudes and behaviors that reflect the sanctioned worldview of the

dominant cultural group within our society (Suzuki, Meller, & Ponterotto, 1996). This

worldview considers individuals as isolates and values individualism. Thus, these

assessment tools are not responsive to resilient attitudes among persons from cultural

groups that do not share the dominant worldview. In addition, they are not responsive

to the psychological effects on identity formation of the devaluation experienced by

those who are not part of the dominant cultural group. Many women and many

subordinated cultural groups hold a different worldview in which individuals experience

themselves, not as isolates, but as in-connection. Miller and her colleagues point out

that women experience themselves in relational contexts. It is from these relational

contexts that they derive an empowered sense of self (Miller, 1976) (Jordan, Kaplan,

Miller, Stiver, & Surrey, 1991). Sue emphasizes that, for cultures whose behavior and

attitudes are guided by a worldview of connectedness, there are beneficial forms of

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external locus of control (e.g. family, community, and the sacred aspect of life) whose

effects are not measured in typical locus of control scales (Sue, 1978; Sue & Sue,

1981). Both Miller and Sue, among others, further point out that a primary source of

diminished self-confidence for women and individuals from subordinated cultural groups

is socially sanctioned devaluation.

2. Existential-religious perspective: Existential philosophy has tended to support

an aspect of our society’s dominant worldview by suggesting that humans are

essentially alone (May & Yalom, 1989; Yalom, 1981). Proponents of an existential-

religious perspective, however, have argued that, while individuals must take full

responsibility for their actions and lives, they can derive meaning from the experience of

relationship with life’s spiritual core. Tillich and Frankl suggest that a primary cause of

an individual’s most fundamental experience of anxiety is the perception that life lacks

intrinsic meaning (Frankl, 1959; Frankl, 1969; Tillich, 1952). In addition, they have

suggested that a primary source of psychological strength can be found in a relationship

with the transcendent reality (Frankl, 1966; Tillich, 1952). Thus, meaning in life can be

experienced, not simply as a functional derivative of one’s personal goals or work, but

as an ontological attribute of life itself. In this worldview, individuals are fundamentally

not alone. Though they are personally responsible for determining the meaning in their

lives, such meaning is discovered through relationship with the sacred aspect of life.

These critical perspectives suggest that operational definitions of the control and

meaning dimensions are inadequate if they exclude attitudes that can emerge from an

individual’s sense of connection with other people or a transcendent reality. They are

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inadequate because they are not responsive to a full range of positive attitudinal coping

styles. Whether individuals perceive themselves as connected to members of their

family, their community, God, or a mixture of these three factors, receiving help from

such trustworthy sources can buffer activation of the stress response in substantial

ways.

As a third-generation positive attitudinal scale, the IPPA was developed to

address these limitations in the conceptualization of the control- and meaning-

dimensions.

1. Control Dimension: Self-Confidence During Stress (SCDS)

The IPPA is built upon the hypothesis that the stress-buffering aspects of control

derive from the perception that stressful events are under control, rather than from the

perception that the individual is in control. Perceptions that events are under control

exist on a continuum. The range of this continuum includes perceived internal locus of

control, positive forms of external locus of control, and habitually calm responses

reflective of perceptions of ontological security. Thus, the Self-Confidence During

Stress sub-scale of the IPPA includes 3 types of attitude. The first type measures

perceived internal locus of control during stressful situations. Examples are: “When I

need to stand up for myself, I can do it quite easily,” “I feel adequate when I am in

difficult situations,” “I react to problems and difficulties with no frustration.” The second

type measures positive forms of external locus of control. Examples are: “In a difficult

situation, I am confident that I will receive the help that I need,” “During times of stress, I

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do not feel isolated and alone.” The third type measures habitually calm responses

reflective of perceptions of ontological security. Examples are: “During stressful

circumstances, I am never fearful,” “When there is a great deal of pressure being placed

on me, I remain calm.” Although these three types of attitude differ from each other,

factor analyses suggest that they are related. Thus, the continuum of attitudes

measured by the Self-Confidence During Stress sub-scale appears to have structural

integrity.

2. Meaning Dimension: Life Purpose and Satisfaction (LPS)

The second dimension of the IPPA is based on the hypothesis that meaning-

based attitudinal resources also exist on a continuum. The range of this continuum

includes generalized perceptions of life satisfaction, personally constructed forms of

meaning, and ontologically derived forms of meaning. Thus, the Life Purpose and

Satisfaction (LPS) scale also contains three types of items. The first type measures

generalized life satisfaction. Examples are: “My daily activities are a source of

satisfaction,” “During most of the day, my energy level is very high.” The second type

measures personally constructed forms of meaning. Examples are: “I feel that the work

I am doing is of great value,” “At this time, I have clearly defined goals in my life,” “I feel

that my life so far has been productive.” The third type measures the ontological

dimension of meaning. Examples are: “When I think deeply about life, I feel there is a

purpose to it,” “When sad things happen to me or other people, I continue to feel

positive about life,” “Deep inside myself, I feel loved,” “I do not feel trapped by the

circumstances of my life.” Although these three types of attitude are different from each

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other, factor analyses once again suggest their relatedness. Thus, the continuum of

attitudes measured by the Life Purpose and Satisfaction sub-scale appears to have

structural integrity.

3. Unifying Concept: Confidence in Life and Self (CLS)

While the IPPA was designed to be a multidimensional instrument, the sub-

scales within the IPPA were conceptualized as complementary aspects of a unified

positive worldview, Confidence in Life and Self (CLS). Thus, while both SCDS and LPS

are hypothesized to contain independent stress-buffering effects, and while an

individual’s scores on the two sub-scales can be different, an optimally positive

worldview is hypothesized to include strength in both dimensions. The psychometric

properties of the IPPA demonstrate a mixture of convergence and divergence between

the two sub-scales that this conceptual model anticipates. Factor analyses distinguish

between the two sub-scales. At the same time, the reliability of the unified scale, as

well as inter-scale correlation, have been high. In addition, research data suggest that

high scores on the total IPPA are often more strongly associated with positive outcomes

than high scores on the individual sub-scales. Thus, there is an aggregate, or

complementary, effect between the two sub-scales. These data lend support to the

validity of the hypothesized construct, Confidence in Life and Self, as a reflection of a

unified positive worldview.

 

B. Measuring Internalized Spirituality: The INSPIRIT

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The value of religiosity or spirituality in individual and social health has been a

matter of debate (Wulff, 1996). Aspects of religiosity have been associated with

neurosis (Dittes, 1969; Pruyser, 1991), intolerance of ambiguity (Budner, 1959),

suggestibility (Fisher, 1964), dogmatic authoritarianism (Rokeach, 1960), racial

prejudice (Allport, 1966), and sexism (Spretnak, 1982). Nonetheless, evidence

suggesting that religious factors may have a broad range of beneficial effects continues

to grow (Miller & Thoreson, 1999). Some of the most pronounced effects have been

observed in the area of mental health (Bergin, Masters, & Richards, 1987; Gartner,

Larson, & Allen, 1991; Hood, Hall, Watson, & Biderman, 1979; Larson et al., 1992;

Poloma & Gallup, 1991). In addition, a growing body of research suggests benefits

within the area of physical health (Kass et al., 1991b; Koenig, 1997; Levin, 1994).

Further, there has been considerable documentation of these positive effects in the area

of substance abuse (Gorsuch, 1995; Marlatt & Kristeller, 1999).

1. Religion and Spirituality as Overlapping Concepts

Although spirituality and religiosity are overlapping concepts, it has been useful

to distinguish between them when developing an operational definition for empirical

research (Kass et al., 1991b). Religiosity generally refers to participation in an

organized religion. Spirituality, on the other hand, refers to the quality of the relationship

that an individual experiences with the sacred aspect of life. This distinction emerges

from Allport’s seminal differentiation between intrinsic and extrinsic religiosity, in which

intrinsic religiosity (internalization of religious values and experience) provided greater

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protective effects against racial prejudice than extrinsic religiosity (religious participation

for utilitarian benefits like social support and status) (Allport & Ross, 1967). Subsequent

to Allport’s research, the term spirituality has become somewhat synonymous with his

term intrinsic religiosity. However, because the term spirituality sometimes connotes a

superficial approach to religious development, Kass employs the term internalized

spirituality to connote a deeply experienced, internalized relationship with the sacred

aspect of life. Thus, internalized spirituality may be a more precise indicator of the

health benefits of religiosity than a more extrinsically oriented construct.

2. Characteristics of Internalized Spirituality

Kass has suggested two primary characteristics of internalized spirituality: 1)

subjectively meaningful experiences that have demonstrated to an individual that the

sacred aspect of life (God or Higher Power) exists, 2) perceptions of closeness with the

sacred aspect of life, in which God is experienced as a core aspect of the individual’s

self. These experiences of the spiritual core (whose association with health-related

variables will be reviewed in the following section of this manual) can serve as a health-

promoting resource by providing individuals and communities with an ontological

foundation for the formation of the resilient worldview, Confidence in Life and Self.

It should be noted, of course, that positive outcomes related to internalized

spirituality can not be construed as objective proof of the existence of the sacred aspect

of life. Internalized spirituality is a subjective phenomenon. However, social psychology

has demonstrated that subjective attitudinal constructs can affect health outcomes. As

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a consequence, while not verifying God’s existence, the scientific study of internalized

spirituality can demonstrate the stress-buffering effects of this subjectively experienced

phenomenon. The mechanism for this effect appears to be cognitive re-structuring in

which internalized spirituality promotes internal locus of evaluation and a stress-

buffering worldview (Kass, 1998a). Thus, internalized spirituality may provide individuals

with inner strength that can mediate the effects of external stress.

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IV. Summary of Research

A. Inventory of Positive Psychological Attitudes (IPPA-32R)

1. Confirmation of Multidimensional Structure

Confirmation of the hypothesized multidimensional structure of the IPPA was

obtained using principal components and common factor analyses. In these

procedures, an item pool is differentiated mathematically into factors based on shared

patterns of response sets. When these mathematically derived factors match

hypothesized theoretical constructs, the conceptual structure of the questionnaire can

be considered sound.

Using a sample of 368 adults (172 outpatients in behavioral medicine treatment,

88 undergraduate students, 108 graduate students), principal components analysis with

varimax rotation differentiated items on the IPPA-30 into 2 factors corresponding to the

hypothesized theoretical factors SCDS and LPS (Kass et al., 1991a). Factor 1

(eigenvalue, 10.32; variance explained, 34.38%) contained the hypothesized 17 items

of the LPS scale. Item loadings ranged from .45 to .76. Factor 2 (eigenvalue, 2.29;

variance explained, 7.62%) contained the hypothesized 13 items of the SCDS scale.

Item loadings ranged from .46 to .68.

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Despite well-differentiated loading patterns, convergence between the factors

could also be observed. One LPS item loaded above .40 on the SCDS scale. Similarly,

2 SCDS items loaded above .40 on the LPS scale. This degree of convergence was

considered acceptable because these factors are hypothesized to be complementary

aspects of an underlying positive worldview.

Table 1.1 reports factor loadings of the IPPA from a second, confirmatory study

with a larger sample. This study was conducted by Kass and colleagues with 1,029

adult employees at a large corporation (472 females, 554 males, 90.7% Caucasian).

The initial analysis of this data, without factor analytic procedures, was reported by

Zuttermeister, Kass, Geiss, and Friedman (Zuttermeister, Kass, Geiss, & Friedman,

1992). In this study, common factor analysis with varimax rotation was employed.

Using an initial pool of 54 items (chosen from the original item pool through which the

IPPA was developed), an exploratory factor analysis retained 17 items as factor 1.

These items belonged to the hypothesized LPS scale. Additionally, 13 items were

retained as factor 2. These items belonged to the hypothesized SCDS scale. A

confirmatory common factor analysis was then conducted using only the 30 items.

Loadings for the LPS factor ranged from .403 to .739. Loadings for the SCDS factor

ranged from .391 to .648. Once again, despite substantial divergence, there was some

convergence. Two LPS items loaded above .40 on the SCDS scale. One SCDS item

loaded over .40 on the LPS scale. This degree of convergence was again considered

acceptable given the hypothesized complementary nature of the two scales (Kass,

1998b).

25

Subsequently, the factor structure of the IPPA-32R was also tested. Kass

performed common factor analyses with varimax rotation on data from a sample of 309

adults (55% female, 45% male, 90% White). An exploratory analysis with an

unspecified number of factors differentiated 2 factors, corresponding to the LPS scale

and the SCDS scale. The first factor (eigenvalue, 8.89; 27.8% variance explained)

included the 17 items of the LPS scale. Factor loadings ranged from .432 to .815. The

second factor (eigenvalue, 6.85; 21.4% variance explained) included the 15 items of the

SCDS scale. Factor loadings ranged from .391 to .759. Once again, despite clear

factor differentiation, a degree of convergence was found. One item from the LPS scale

loaded above .4 on the SCDS scale. Four items on the SCDS scale loaded above .4 on

the LPS scale. These results suggest that the factor structure of the IPPA-32R is highly

analogous to the factor structure of the IPPA-30 (Kass, 1998b).

In summary, factor analyses have consistently supported the theorized multi-

dimensional structure of the IPPA. The LPS and SCDS scales are different from each

other. At the same time, these analyses show that the two sub-scales are not fully

orthogonal. This convergence suggests that they are complementary aspects of an

underlying positive worldview. The degree to which Confidence in Life and Self can be

considered a structural unit was then assessed through tests of reliability.

2. Reliability

26

To evaluate the reliability of the IPPA, the internal consistency of the scales (i.e.

consistency in the patterns of responses) was determined. This criterion of reliability,

also called homogeneity, was measured using Cronbach’s alpha coefficient of reliability.

In the sample of 368 adults, Kass and his colleagues found Cronbach’s alpha

coefficients to be consistently high for each IPPA-30 scale, both for the sample as a

whole and for each sub-group within the sample. For the entire sample, Cronbach’s

alpha coefficients were: SCDS, .86; LPS, .91; Total IPPA (CLS), .93. These reliability

coefficients were similar for each sub-group (behavioral medicine outpatients,

undergraduate students, and graduate students). The range of alpha coefficients was:

SCDS, .80 - .86; LPS, .87 - .92; Total IPPA (CLS), .88 - .94 (Kass et al., 1991a).

In the sample of 1,029 corporate employees, Kass and his colleagues found

Cronbach’s alpha coefficients to be consistently high for each IPPA-30 scale, both

within the whole sample and within sub-groups sorted by gender. For the SCDS sub-

scale, the alpha coefficients were: total group, .855; females, .842; males, .858. For the

LPS sub-scale, the alpha coefficients were: total group, .912; females, .908;

males, .914. For the total IPPA (CLS), the alpha coefficients were: total group, .930;

females, .926; males, .934 (Zuttermeister et al., 1992).

In the sample of 309 adults, Kass also found Cronbach’s alpha coefficients to be

high for each IPPA-32 scale. For SCDS, the alpha was .917. For LPS, the alpha

was .942. For CLS (total IPPA), the alpha was .957. As anticipated, the revisions in the

27

SCDS scale strengthened its reliability. In addition, these revisions strengthened the

reliability of the total IPPA (Kass, 1998b).

In summary, these data help to confirm the psychometric structure and reliability

of the IPPA scales. Both the SCDS and LPS sub-scales have a high degree of internal

consistency. They are different from each other (as shown in the factor analyses), and

they each display a high degree of homogeneity. At the same time, the CLS scale (total

IPPA) also shows a high degree of internal consistency. These findings suggest that

Confidence in Life and Self is a unified construct containing complementary aspects.

3. Construct Validity

Tests of construct validity determine whether a scale actually measures its

hypothesized conceptual domains. Construct validity of the IPPA was evaluated

through two lines of inquiry. First, correspondences between the new scale and other

scales that are recognized to measure related domains were measured. Second, the

ability of the IPPA to differentiate between population samples was examined, using

populations where these attitudinal domains are safely assumed to be different.

a. Correspondence with comparable scales

Using a sample of 368 adults, Kass and his colleagues compared the IPPA to

several other scales measuring constructs related to emotional well being. The first

scale was McNair’s Bi-Polar Profile of Mood States (McNair, Lorr, & Droppleman, 1981).

This scale measures 6 mood constructs related to emotional well being:

28

Composed/Anxious, Agreeable/Hostile, Elated/Depressed, Confident/Unsure,

Energetic/Tired, Clearheaded/Confused. The second scale was Bradburn’s Affect

Balance Scale, a measure of life satisfaction (Bradburn, 1969). The third scale was

Rosenberg’s Self-Esteem Scale (Rosenberg, 1965). The fourth scale was The UCLA

Loneliness Scale (Russell, Peplau, & Ferguson, 1978). Table 1.2 presents findings

from this study. As anticipated, there were positive correlations between the IPPA

scales and positive moods, life satisfaction, and self-esteem (Table 1.3). There was a

negative correlation between the IPPA and loneliness. The strength of the positive and

negative correlations ranged from .38 to .79, with most falling in the .50 to .65 vicinity.

All correlations were significant at p <.0001 (Kass et al., 1991a).

Using a sample of 1,029 corporate employees, Kass and colleagues compared

the IPPA to Derogatis’ Symptom Checklist-90R (SCL-90R). This measure of psychiatric

symptoms contains 9 sub-scales: Hostility, Depression, Anxiety, Phobic Anxiety,

Paranoid Ideation, Psychoticism, Obsessive-Compulsivity, Interpersonal Sensitivity, and

Somatization. In addition, a Global Severity Index can be derived (Derogatis, 1983).

Significant negative correlations, ranging from r = -.21 to r = -.64 (p <.0001), were found

between the IPPA and all SCL-90R scales (Zuttermeister et al., 1992). Thus,

Confidence in Life and Self (CLS) was negatively related to hostility, depression,

anxiety, and Global Severity (Table 1.3).

The data from these studies suggest two conclusions. First, there is a

reasonable degree of correspondence between the IPPA and the related attitudinal

scales. In the social sciences, correlations ranging from r =.500 to r =.600 are

29

considered to reflect a high degree of similarity. It is reasonable to conclude, then, that

the IPPA scales measure positive attitudinal domains related to these other scales.

However, it is important to note that if there were complete correspondence between

the IPPA and the other attitudinal scales, they would be synonymous. In that event, the

IPPA scales could not be considered unique attitudinal constructs. This logic leads to

the second, and somewhat converse, conclusion. There are sufficiently reasonable

divergences between the IPPA scales and the other scales. Correlations ranging from r

=.500 to r =.600 reflect a shared variance (r-squared) of 25%-36%. Thus, the scales

also perform with a reasonable amount of difference, and cannot be considered

synonymous. In conclusion, the IPPA scales tap positive attitudinal domains (Self-

Confidence During Stress, Life Purpose and Satisfaction, and Confidence in Life and

Self) that are similar to, but distinct from, those tapped by other scales.

b. Discrimination between populations

To test the discriminative validity of the IPPA, Kass and his colleagues utilized

their sample of 368 adults, composed of three different sub-groups. It was

hypothesized that healthy graduate students with defined and attainable career goals

would have the highest levels of positive attitudes; that outpatients facing uncertain

medical prognoses would have the lowest levels of positive attitudes; and that healthy

undergraduates with somewhat less defined career goals would score in between.

Scores were compared using an analysis of covariance (ANCOVA) with sex, age, race,

and education as covariates. Post hoc comparisons were obtained using Newman-

Keuls tests. The results confirmed the hypotheses, with one exception. The graduate

30

and undergraduate students scored significantly higher than the medical outpatients on

all 3 IPPA scales. The graduate students scored significantly higher than the

undergraduate students on the LPS and CLS scales. The graduates, however, did not

score higher than the undergraduates on SCDS. Although this latter finding did not

support the original hypothesis, the differences between the medical outpatients and the

student groups suggested that the discriminative powers of the SCDS scale were

sufficient. Thus, all 3 IPPA scales demonstrated a substantial ability to discriminate

between differing populations (Kass et al., 1991a).

In conclusion, the data from these studies lend strong support for the construct

validity of the IPPA scales.

4. Outcome Research

As described in concept section III-A, stress can contribute to psychological and

physical illnesses through two pathways: autonomic hyperarousal and the elicitation of

health-risk behaviors. Thus, health-promoting effects of resilient attitudes should be

observable in three ways:

1)     reductions in psychological symptoms related to hyperarousal;

2)     reductions in stress-related medical symptoms;

3)     reductions in health-risk behaviors.

31

Ideally, investigations of the utility of the IPPA should include prospective, long-term

research seeking evidence that Confidence in Life and Self helps individuals maintain

low levels of psychological symptoms, stress-related medical illnesses, and health-risk

behaviors. To date, long-term prospective research has not been conducted with the

IPPA. However, short-term research studies with chronic pain patients, behavioral

medicine outpatients, and healthy adults offer evidence that the positive attitudes

measured by the IPPA are related to reductions in these areas. 

a. Improvements in psychological symptoms and chronic pain

In a sample of 228 outpatients being treated for chronic pain within a 10-week

behavioral medicine program, Kass and his colleagues found the IPPA associated with

reductions in psychological symptoms and stress-related medical symptoms (Kass et

al., 1991a). Psychological symptoms were measured by the Global Severity Index

(GSI) of the SCL-90R (Derogatis, 1983). Stress-related medical symptoms were

measured by the four scales of the Multidimensional Pain Inventory (Kerns, Turk, &

Rudy, 1985) and the McGill Pain Questionnaire (Melzack, 1975). Data was gathered

pre- and post-treatment. Increases in CLS were associated with decreases in the GSI

(r = -.57; p < .01). Increases in CLS were also associated with decreases in pain

severity (r = -.29; p < .01; MPI-1), interference (r = -.28, p < .01; MPI-2), affective

distress (r = -.36; p < .01; MPI-4), and the global pain rating index of the McGill

Questionnaire (r = -.20, p < .02). In addition, increases in CLS were associated with

increases in life control (r = .37, p < .01; MPI-3). These data suggest that increases in

32

CLS contribute to decreases in psychological symptoms and chronic pain among these

medical outpatients.

In this study, Kass and his colleagues also sought to determine whether

decreases in pain ratings were better explained by increases in positive attitudes or

decreases in psychological symptoms. These opposing variables, while related, are not

mirror images. Increases in positive attitudes may be a more useful predictor for

decreases in pain than decreases in psychological symptoms. Multiple regression

analyses were performed with the pain scales as dependent variable and the IPPA

(CLS) and SCL-90R (GSI) as co-independent variables. These analyses showed the

IPPA to be the more effective predictor for pain severity (MPI-1) and pain interference

(MPI-2). With life control (MPI-3) and affective distress (MPI-4), the most effective

explanatory model was the interaction between CLS and GSI. The GSI was the more

effective predictor only on the McGill PRI. Thus, in 4 of the 5 pain measures, the IPPA

provided superior or necessary explanatory data. These results suggest that increases

in CLS can contribute substantively to reductions in stress-related chronic pain.

b. Improvements in psychological and medical symptoms

In a related study, Tate found increases in CLS to be associated with decreases

in psychological symptoms and decreases in combined medical-psychological

symptoms (Tate, 1994). This study was conducted at a different behavioral medicine

clinic, utilizing 183 adult outpatients in a 9-week program under treatment for a variety

of stress-related illnesses. Pre- and post-treatment, and six-month follow-up, data were

33

gathered using the IPPA, the SCL-90-R, and Leserman’s Medical and Psychological

Symptoms Checklist (Borysenko, 1989). The MPSCL measures 33 stress-related

medical symptoms on 3 dimensions (frequency, degree of discomfort, and degree of

interference). In addition, the MPSCL measures 13 stress-related behaviors, 14

negative thought patterns, and 15 negative affective states on one dimension (degree to

which the symptoms bother the individual). A global score for these dimensions is

obtained (MSP). Spearman rank order correlations were used to compare relationships

between the change scores of these variables.

Tate found negative correlations between changes in CLS and GSI from pre- to

post-treatment (r = -.504), from post-treatment to 6-month follow-up (r = -.394), and from

pre-treatment to 6-month follow-up (r = -.571). Significance values were p < .001.

Thus, increases in CLS were strongly associated with reductions in psychological

symptoms.

Tate also found negative correlations between CLS and MPS scores from pre- to

post-treatment (r = -.550), from post-treatment to 6-month follow-up (r = -.468), and from

pre-treatment to 6-month follow-up (r = -.625). Significance values were p < .001. The

global MPS score does not differentiate between medical, behavioral, and psycho-

affective symptom dimensions. However, a more detailed review of these findings

suggests increases in CLS to be associated with all dimensions of the scale, including

medical symptoms.

c. Associations with lower levels of health-risk behaviors

34

In a cross sectional study employing a sample of 735 healthy adults participating

in a survey conducted through a health-related magazine, Kass found Confidence in

Life and Self to be associated negatively with cigarette smoking and overeating (Kass,

2000b). There were 449 women (61%) and 286 men (49%). The composition of the

sample was predominantly white (88%). Mean age for the group was 42.6 years (SD =

11.5 years).

This study used a self-report question that asked, “During the average day, how

often do you eat a meal that contributes to more body weight than your doctor

recommends?” Twenty-seven percent of the group (N = 195) reported “Never.” Fifty

percent (N = 366) reported “One time per day.” Fourteen percent (N = 104) reported

“Twice per day.” Six percent (N = 41) reported “Three times per day.” Two percent (N

= 13) reported “Four times per day.” Two percent (N = 15) reported “Five times per

day.” Relationships between these categories of eating behaviors and CLS were

measured using Pearson chi-square statistics. Results showed a negative relationship

between CLS and eating behaviors (Pearson chi-square = 102.09; p = .003).

This study also asked, “During the average day, how much do you smoke

cigarettes?” Eighty-five percent of the group (N = 623) reported “Never.” Seven

percent (N = 52) reported “½ pack.” Five percent (N = 40) reported “1 pack.” Two

percent (N = 14) reported “1 ½ packs.” One percent (N = 5) reported “2 packs.” Thus,

this group smoked much less than they overate. Nevertheless, a modest negative

relationship was also apparent between CLS and smoking (Pearson chi-square = 91.6;

p-value = .001).

35

In conclusion, this outcome research suggests that psychological resilience, as

measured by the positive worldview Confidence in Life and Self, can serve as a

protective factor helping to reduce psychological symptoms related to stress, medical

symptoms related to stress, and health risk behaviors. Having examined the

psychological and physical health benefits of resilience, we can now examine the role

that internalized spirituality plays in the formation and maintenance of psychological

resilience.

B. Index of Core Spiritual Experiences (INSPIRIT-R)

1. Confirmation of Unidimensional Structure

The unidimensional structure of the INSPIRIT was developed and confirmed

using principal components analyses with varimax rotation.

The initial sample was composed of outpatients in a hospital-based behavioral

medicine program (N=83). The sample ranged in age from 25-72 years (mean=46.2,

SD=11.2). It was predominantly female (66%) and white (94%). Religious backgrounds

included Catholic (37%), Protestant (23%), and Jewish (40%). Educational background

was high (mean = 16.1 years, SD = 2.5).

The original item pool of the INSPIRIT contained 11 questions. Items 1-4 and 8-

11 were questions (or modifications of questions) developed by the National Opinion

Research Center (NORC) in conjunction with Greeley (Davis & Smith, 1985, Greeley,

1974 #83). Items 5, 6 and 7 were newly developed for the INSPIRIT. The principal

36

components analysis retained items 1-7 as a single factor. Items 8-11 loaded into two

additional factors. Items 1-7 contained the two key aspects of core spiritual

experiences. (Items 3, 5, and 7 identify experiences leading to a conviction of God’s

presence. Items 1, 2, 4, and 6 measure behaviors and attitudes that would be present

among individuals experiencing closeness to God.) Consequently, items 1-7 were

retained as the final version of the INSPIRIT. A confirmatory analysis was then

conducted using the 7 items. Table 2.1 presents the factor loadings from this analysis

(Kass Study-1). The loadings ranged from .69 to .85. The eigenvalue for this factor was

4.42, explaining 63% of the variance in the matrix (Kass et al., 1991b).

VandeCreek reported an independent replication of this factor structure in 1995.

Data were gathered from 371 individuals. This sample was composed of 247 medical

outpatients at a cancer hospital and 124 family members in a surgical waiting room

(VandeCreek et al., 1995). The group was predominantly white (91%) and female

(60%). Mean age for the group was 50 years, ranging from 17 to 78. An exploratory

principal components analysis retained the seven items in a single factor. These

loadings were substantive, but lower than in Kass’ original study. They ranged

from .163 to .620 (with five items loading in the .503 to .572 level). The eigenvalue for

this factor was 3.46, explaining 49.4% of the variance in this matrix (Table 2.1).

In a subsequent study of 735 individuals, Kass found additional confirmation for

this factor structure (Kass, 2000a). This sample contained 449 women (61%) and 286

men (39%) participating in a survey conducted through a health-related magazine.

Mean age was 42.59 (SD = 11.54). The sample was predominantly White (88%), with

37

smaller numbers of African-Americans (2.7%), Asian-Americans (4.0%), Hispanics

(1.6%) and Native Americans (1.8%). The religious affiliations of the sample included

Protestant (41%), Catholic (23%), Jewish (2.6%), other (12.4%), and no affiliation

(21%). All seven items loaded into a single factor. Factor loadings ranged from .699

to .823. The eigenvalue for this factor was 4.05, explaining 58% of the variance in this

matrix (Table 2.1, Kass Study-2).

In summary, principal components analyses of three separate samples have

consistently supported the hypothesized unidimensional structure of the INSPIRIT.

Conceptually, the INSPIRIT taps two aspects of spirituality: an experiential aspect

(experiences of God’s existence) and a relational aspect (God experienced as close to

the person and as an in-dwelling spiritual core). Together, these complementary

aspects are conceptualized as experiences of the spiritual core. The results from these

principal components analyses confirm the unidimensional nature of the 7 items in the

INSPIRIT and lend support to their hypothesized conceptual structure.

2. Reliability

To evaluate the reliability of the INSPIRIT, Cronbach’s alpha coefficient was

utilized to determine the strength of the internal consistency of the scale.

In their original sample of 83 behavioral medicine outpatient adults, Kass and his

colleagues found Cronbach's Alpha reliability coefficient to be .90. The mean score for

the INSPIRIT was 2.8 (SD=.83) (Kass et al., 1991b).

38

In VandeCreek’s study of 371 outpatients and family members, Cronbach’s alpha

coefficient was .81. The mean score for the INSPIRIT was 2.97 (SD = .74)

(VandeCreek et al., 1995).

In Kass’ subsequent study of 735 respondents in a health-related magazine

survey, reported in this manual, Cronbach’s alpha reliability coefficient was .87. The

mean score for the INSPIRIT was 3.3 (SD = .62) (Kass, 2000a).

The reliability score in VandeCreek’s sample was somewhat lower than the two

studies by Kass. These results were consistent with VandeCreek’s principal component

analyses where the factor loadings were also lower than in Kass’ studies. Nonetheless,

VandeCreek’s findings reflected a substantial degree of homogeneity in the INSPIRIT.

As a whole, the data from the three studies suggest a high degree of internal

consistency among the seven items of the INSPIRIT scale.

3. Construct Validity

The construct validity of the INSPIRIT was evaluated through two lines of inquiry.

The first approach evaluated the instrument’s convergence (and appropriate

divergence) with other scales that measure related domains. The second approach

measured the ability of the INSPIRIT to differentiate between sub-groups within a

sample population, where these sub-groups can reasonably be hypothesized to score

differently on this instrument.

a. Correspondence with comparable scales

39

In the validation study of the INSPIRIT, Kass hypothesized a positive relationship

between experiences of the spiritual core and intrinsic religiosity. He used the Intrinsic

Religious Orientation scale from Allport’s Religious Orientation Inventory to test this

hypothesis (Allport & Ross, 1967). Kass further hypothesized a weak negative

relationship between the INSPIRIT and Allport’s Extrinsic Religious Orientation scale.

This hypothesis was based on research by Allport and Feagin who found minimal

relationships between extrinsic and intrinsic orientations (Allport, 1966, Allport, 1967,

Feagin, 1964).

The correlation of the INSPIRIT with the Intrinsic scale of the ROI was r=.69,

(p = .0001). The correlation with the Extrinsic Religious Orientation scale was weakly

negative (r = -.26). Though this second finding was slightly outside an acceptable

confidence level (p = .06), these results offered satisfactory substantiation that the

INSPIRIT scale measured a spiritual construct that was highly intrinsic in its orientation.

At the same time, there was sufficient divergence between Kass’ INSPIRIT and Allport’s

Intrinsic Religious Orientation scale to suggest that the new scale was not redundant.

Further evidence for this aspect of the INSPIRIT’s construct validity has been

supplied by VandeCreek (VandeCreek et al., 1995). In his study of 371 outpatients and

family members, VandeCreek examined the relationship between the INSPIRIT and

Hoge’s Intrinsic Religious Motivation Scale (Hoge, 1972). The Pearson product

moment correlation for this relationship was r = .61 (p < .05). This result reflects a

substantial degree of convergence between the INSPIRIT and another validated

measure of intrinsic religiosity. At the same time, this result reflects an appropriate

40

degree of divergence between the scales to suggest unique qualities within the

INSPIRIT that Hoge’s scale does not tap.

b. Discrimination between population sub-groups

Among the outpatients in the behavioral medicine program where Kass

conducted his initial validation study, there were marked differences among the

participants regarding knowledge about, and previous use of, meditation (Kass et al.,

1991b). Meditation is a spiritual practice associated with increased frequency and

intensity of spiritual experiences (Davidson, 1976; Kornfield, 1979; Walsh, 1978).

Meditation is practiced by virtually all of the major spiritual traditions in the West and the

East, though it is designated by different terms within these many traditions. Some

outpatients in this study had been meditating for several years. Others had never

meditated before. Meditation research has suggested that its physiological and

psychospiritual effects become apparent following approximately 1 month of regular

practice. Consequently, Kass hypothesized that outpatients with a history of meditation

longer than 1 month would score higher on the INSPIRIT scale than outpatients with a

shorter history (0-1 month).

To test this hypothesis, Kass and his colleagues performed an Analysis of

Covariance (ANCOVA) comparing INSPIRIT scores among the patient sub-groups

(Table 2.2). Demographic data (age, gender, and educational level) were utilized as

control variables. A significant difference (p = .04) was found between outpatients who

had been meditating one month or less (adjusted mean = 2.70) and those who had

41

been meditating for more than 1 month (adjusted mean = 3.15). Interestingly, women

scored significantly higher on the INSPIRIT than men in this sample. The role of

gender, however, did not interact with, or confound, these results. These results

demonstrated the ability of the INSPIRIT scale to differentiate between different sub-

groups of a population.

In summary, these data reflect a substantial degree of construct validity for the

INSPIRIT. The INSPIRIT scale measures intrinsic, internalized aspects of spirituality.

At the same time, it measures an aspect of intrinsic religiosity that is not tapped by

these other scales. In addition, these data provided reasonable justification for the use

of the INSPIRIT in outcome research to determine whether or not internalized spirituality

contributes to psychological and physical health.

4. Outcome Research

As described in concept section III-B, the primary pathway through which Kass

has hypothesized internalized spirituality to contribute to mental and physical health is

through its role as a resource for resilience. While some investigators of the

relationship between religion and health hypothesize prayer to be a healing agent ipso

facto, Kass suggests that a more productive approach to the health benefits of

spirituality lies in understanding the effect of internalized spirituality on an individual’s

coping mechanisms. Thus, while the development of internalized spirituality may

sometimes serve as an ameliorative agent for pre-existing symptoms and disorders

42

(i.e., those with a prominent stress component), the primary significance of internalized

spirituality to the fields of mental and physical health is in the area of prevention.

As a consequence, the first goal of research with the INSPIRIT has been to

examine the relationship between internalized spirituality and the formation of a resilient

worldview. The second goal of research with the INSPIRIT has been to examine the

relationship between internalized spirituality and reductions in health-risk behaviors.

The third goal of research with the INSPIRIT has been to examine the relationship

between internalized spirituality and reductions in stress-related physical symptoms

associated with medical illnesses.

Ideally, investigations of internalized spirituality as a preventive resource should

include prospective, long-term research. To date, the most extensive prospective study

with the INSPIRIT spans a 9 month period. Thus, more extensive research using the

INSPIRIT is required before internalized spirituality can be established as a life-long

preventive resource. However, the moderate-length and short-term research conducted

to date with the INSPIRIT demonstrates robust relationships between internalized

spirituality and the hypothesized health outcomes outlined above.

a. The formation of a resilient worldview

In the initial validation study of the INSPIRIT, Kass and his colleagues examined

changes on the Inventory of Positive Psychological Attitudes among 83 adult

outpatients in a 10-week hospital-based behavioral medicine program (Kass et al.,

1991b). Medical diagnoses within this sample included musculoskeletal disorders,

43

chronic pain, gastrointestinal disorders, hypertension and cancer. The patients included

individuals coping with recent diagnoses of life-threatening illnesses as well as patients

coping with long-term chronic disorders. Each patient had been referred to this

treatment program by a physician who felt that the patient could benefit from

improvements in coping skills. The patients participated in a psychoeducational

program where they were taught to meditate and to examine the cognitive components

of their reactions to stress. A majority of these outpatients expressed feelings of anxiety

and depression as they entered this treatment program. Thus, a primary goal of this

program was to help them cope more effectively with the stress related to their medical

disorders. The sample ranged in age from 25-72 years (mean=46.2, SD=11.2). It was

predominantly female (66%); and white (94%). Religious background within the sample

was diverse (Catholic, 37%; Protestant, 23%; Jewish, 40%). The educational

background of the group was high (mean = 16.1 years, SD = 2.5).

The results from this study showed internalized spirituality to be a significant

resource in this coping process. Multiple regressions were utilized to analyze

relationships between the INSPIRIT and psychological resilience. Forward stepwise

regression was employed in which Kass controlled for health status at Time 1 (T1) and

demographic data (gender, age, education). INSPIRIT scores were statistically related

to increases in Life Purpose and Satisfaction (Table 2.3). The regression model

retained LPS at T1, INSPIRIT, and age in its final model, though the effects of age were

not statistically significant. The standardized Beta for the effects of internalized

44

spirituality was B = .15. This model explained 71% of the variance in LPS over the 10-

week treatment program.

It is useful to consider these results more fully. The mean score for the INSPIRIT

was stable in this sample over the 10-week period (T1 = 2.81; T2 = 2.86). Thus, the

sample did not show increases on the INSPIRIT during this treatment period.

Nonetheless, as we have seen, there was variance in INSPIRIT scores (See section IV-

B, 3-b). Those who had been meditating longer prior to the treatment program had

higher INSPIRIT scores. As a consequence, those who came to this treatment program

with already established higher levels of internalized spirituality demonstrated the

greatest increases in Life Purpose and Satisfaction during the treatment program. In

summary, the individuals whose resilience improved most rapidly over the 10-week

period were those who came with a foundation of internalized spirituality. This study

was pivotal in suggesting to Kass that spirituality would best be conceptualized within

the fields of mental and physical health as a preventive resource.

An additional outcome of this study was support for the utility of the specific

INSPIRIT construct as a tool for the investigation of the relationship between spirituality

and resilience. In addition to the INSPIRIT scale, the participants in this study were

asked whether or not they believed in God. A comparable multiple regression analysis

was conducted replacing the INSPIRIT with Belief in God. This analysis found no

relationship between Belief in God and improvements in LPS. Thus, while belief in God

and internalized spirituality are overlapping constructs, belief in God was less useful as

a predictor of improvements in LPS. The most probable explanation for this difference

45

is the lack of clarity in the “Belief in God” construct. Such a construct can include

individuals with deeply internalized forms of spirituality. However, it can also include

individuals with superficial, or highly intellectualized, form of spirituality. Consequently,

questions regarding Belief in God are not sufficiently responsive to variations in the

depth of spirituality to serve as a useful research tool. This study suggests that the

INSPIRIT scale is responsive to these variations and that it fulfills the need for a

research tool that distinguishes between more internalized, and more superficial, forms

of spirituality.

Subsequently, Kass has found further evidence that internalized spirituality can

be a substantive source of psychological resilience. Kass and a group of researchers

studied a sample of 126 adult students at a highly competitive ivy league university who

were enrolled in Master’s Degree programs in the university’s Divinity School (Kass et

al., 1999; Kass et al., 2000b). This site was chosen for several reasons. First, in

response to assumptions within the field of psychology equating spirituality with

dysfunctional ego states, a sample of academically successful, highly religious

individuals provided an ideal means to bring clarity to this debate. Second, because it

was possible that the depth of internalized spirituality would vary within this group of

religious adults, this sample also provided a means to explore the distinction between

religiosity (participation in an organized religion) and internalized spirituality. Third,

because these high achieving individuals were engaged in training and careers that

include substantial levels of stress, this site would yield meaningful information

regarding relationships between internalized spirituality and psychological resilience.

46

This cross sectional field study employed a voluntary, non-randomized sample.

Most of these young adults were in their mid-30’s (Mean = 32.2 years, SD = 9.41).

They were predominantly female (Women = 86; Men = 40). They were predominantly

white (Caucasian = 87%, People of Color = 13%). Their religious affiliations varied

(Protestant = 39.7%, Catholic = 17.5%, Jewish = 3.2%, Muslim = 2.4%, Other = 24.6%,

None = 11.9%). The "other" category in religious affiliation was composed, to a large

extent, of individuals exploring feminist spirituality or Asian meditative disciplines. Most

participants were not in an established relationship (single = 49%, married = 27%,

committed relationship = 15%, divorced or widowed = 9%). Dysfunctional ego states

were measured with Budner’s Intolerance of Ambiguity Scale (Budner, 1959) and the

Symptom Checklist 90-R, a measure of psychiatric symptoms (Derogatis, 1983). In

addition, Kass gathered demographic data related to family structure during childhood

and adolescence, a potential indicator of dysfunctional ego states. Psychological

resilience was measured using the Inventory of Positive Psychological Attitudes.

INSPIRIT scores were high in this sample, while at the same time displaying a

significant degree of variance (Women: Mean = 3.30, SD = .57; Men: Mean = 3.13, SD

= .58). As a consequence, this sample provided a meaningful testing ground for a

relationship between INSPIRIT scores and dysfunctional ego states. No relationship

was found between INSPIRIT scores and Intolerance of Ambiguity (r = -.042; p = .644).

No relationships were found between INSPIRIT scores and psychiatric symptoms:

Obsessive-Compulsive (r = -.032; p = .726); Psychosis (r = .039; p = .672); Paranoia (r

= .007; p = .939); Phobias (r = -.044; p = .638); Somatization (r = .034; p = .715);

47

Interpersonal Sensitivity (r = -.110; .233). In addition, no relationships were found

between INSPIRIT scores and family structure during childhood: intact nuclear family (r

= -.046; p = .609); death of mother ( r = -.016; p= .858); death of father (r = -.020; p

= .821); death of sibling (r = -.097; p = .279); loss of one parent through separation or

divorce (r = .065; p= .471); loss of both parents through separation or divorce (r = .119;

p = .183); composite loss of any members of nuclear family (r = .055; p = .544). In

summary, there was no evidence that experiences of the spiritual core can be

categorically associated with dysfunctional ego states.

Pearson product-moment correlations between internalized spirituality and a resilient

 worldview, on the other hand, were substantial. Positive relationships were found between the

 INSPIRIT and CLS for women (r = .271, p = .013) and for men (men: r = .373, p = .018). To clarify

 these relationships, multiple regression analyses were conducted using CLS as dependent

variable. As part of this study, Kass had identified gender-specific areas of stress that contribute to

decreases in CLS. For women, stress concerning primary interpersonal relationships was

associated with lower CLS. For men, stress concerning academic studies was associated with

lower CLS. To control for these effects, and to examine their interactions with spirituality, Kass

treated these stressors and the INSPIRIT (as well as potentially important demographic factors) as

48

co-independent variables in the regression analysis (Table 2.4). These analyses confirmed the

negative effects of these gender-specific stressors. However, INSPIRIT was retained as the

primary factor contributing to increased levels in CLS for women (Standard Beta = .278, p = .011)

and men (Standard Beta = .383; p = .010). INSPIRIT buffered the negative effects of these

stressors and contributed to increases in CLS. These regression models, which had strong

explanatory value (Women: Multiple R = .401, p = .002; Men: Multiple R = .548, p = .00), lend

considerable support to the hypothesis that internalized spirituality contributes to resilience in both

women and men.

An additional study by Kass adds further credence to this hypothesis. Kass

conducted a cross sectional study employing a sample of 735 individuals participating in

a survey conducted through a health-related magazine (Kass, 2000a). There were 449

women (61%) and 286 men (49%) in this study. The racial composition of the sample

was predominantly white (Caucasian = 88%, Asian = 4%, Black = 2.7%, Native

American = 1.8%, Hispanic = 1.6%, Biracial = .82%, Other = 1.5%). Present religious

affiliation was varied (Protestant = 41%, Catholic = 23%, None = 21%, Jewish = 2.6%,

feminist and earth-based spirituality = .4%, Moslem = .3%, Eastern Orthodox = .14%,

Other = 8.8%). The mean age for the group was 42.6 years (SD = 11.5 years).

To test the association between the INSPIRIT and the IPPA, Pearson product

moment correlations were calculated. Substantial correlations were found in the whole

49

group with CLS (r = .443, p = .000), SC (r = .394; p = .000) and LPS (r = .443; p = .000).

Similar relationships were found for women with CLS (r = .448; p = .000), SC (r = .422;

p = .000), and LPS (r = .432; p = .000). Similar relationships were also found for men

with CLS (r = .444; p = .000), SC (r = .357; p = .000), and LPS (r = .464; p = .000).

In addition to these studies conducted by Kass, several other studies have linked

internalized spirituality (as measured by the INSPIRIT) with resilience. Zinnbauer and

Pargament have found internalized spirituality to be related to increases in positive

sense of self and self-esteem among medical outpatients (Zinnbauer & Pargament,

1998). McBride found that internalized spirituality contributed to functional health

status among adult outpatients in a family medical practice (McBride, Arthur, Brooks, &

Pilkington, 1998). Finally, Easterling found internalized spirituality to contribute to

constructive methods of coping among individuals suffering bereavement (Easterling,

Gamino, Sewell, & Stirman, 1999). This study is particularly meaningful because

Easterling also measured the effects of church attendance on coping. He found

internalized spirituality, and not church attendance, to be the primary predictor of

positive coping. While church attendance (like belief in God) was linked to positive

benefits, these benefits were present only when church attendance was linked with

internalized spirituality.

In summary, there is reasonable evidence that internalized spirituality is

associated with, and contributes to, psychological resilience. This relationship applies

fairly equally to women and to men. However, it needs to be noted that the samples

reported in the studies conducted by Kass have been predominantly white. Although

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there is considerable qualitative literature suggesting that this relationship is relevant to

many African-American communities (Billingsley, 1992; Freedman, 1993), we must

show appropriate restraint in generalizing these conclusions from these studies to

African-Americans and other peoples of color.

b. Reductions in health-risk behaviors

Kass has hypothesized that internalized spirituality, through increases in

resilience, can buffer the effects of gender-specific stressors and reduce health risk

behaviors. Kass has conducted studies that address three such behaviors, particularly

as they affect women’s health: hostility (associated with lung cancer and hypertension),

cigarette smoking (associated with lung cancer and heart disease), and alcohol

dependence (associated with alcoholism and kidney disease).

As part of their study of divinity school students (see discussion above), Kass

and his colleagues examined how internalized spirituality and a resilient worldview may

affect hostility. Table 2.4 reports a multiple regression analysis with hostility as the

dependent variable. INSPIRIT, CLS, stress concerning physical appearance (a gender-

related factor), lack of time for fun, and age were all retained in the final model although

age was not considered statistically significant. Stress concerning physical appearance

and no time for fun contributed to hostility. CLS and INSPIRIT protected against it.

Although CLS was the primary factor associated with lower levels of hostility (a finding

consistent with Kass' model), INSPIRIT was retained in the model as a co-variable.

51

Thus, it retained an independent effect on hostility in addition to its contributions to CLS

(Kass et al., 1999; Kass et al., 2000b).

In a related, but separate, study, Kass and this same group of colleagues studied

cigarette smoking in first year undergraduate women (Kass et al., 2000a). Using a

longitudinal research design, data was collected from 54 young women at the beginning

and end of their first year of undergraduate studies in education or human services.

Students enrolled in a required, 2-semester course in health and fitness were invited to

participate in a study of health without knowing the specific focus of the project. Slightly

more than 50% of the students volunteered. The sample was predominantly white

(87%) and Catholic (48%). Other religious denominations included Jewish (17%),

Protestant (11%), Other (7%), and None (15%). Income levels for the families of most

students ranged from $45-60,000, indicating predominantly lower middle class

backgrounds. Though we did not employ a randomization process, several

characteristics of this sample suggested suitability for this study. The subjects were at

an age (Mean = 18.5 years, SD = 1.4) when smoking patterns are not yet set

(Geronimus, Neidert, & Bound, 1993). The proportion of smokers (25%) was

representative for white women in this age group (NCHS, 1997). The career goals of

the subjects (education or human services) were typical of many young women in our

society. In addition, two characteristics of this college campus contributed to the

suitability of this sample. First, as an urban campus, the psychosocial stressors

experienced by these students were typical of contemporary, young adulthood

(separation from families, high level of autonomy, career and relationship uncertainties).

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Second, as a non-sectarian campus, religious or spiritual commitment was not a

prescribed social norm. The lack of such norms is evident in the sample’s moderate

scores on internalized spirituality. On a scale of 1 to 4 (high), mean scores were 2.72 at

T1 (SD = .60) and 2.66 at T3 (SD = .62).

Bivariate correlations with smoking were calculated at T1. Positive correlations

were found with family income level, prevalence of family members and friends who

smoke, current alcohol usage, and stress concerning physical appearance. This finding

provided initial confirmation regarding the relationship between stress concerning

physical appearance and smoking in young women.

A theoretical model was then constructed for predicting variance in

cigarette smoking at T3 (end of academic year). Variables associated with

smoking at T1 were used in this model, in conjunction with internalized

spirituality, self-confidence, and hostility. Multiple regression analyses were used

to test this model, controlling for demographic factors and cigarette smoking at

T1. Cigarette smoking at T3 served as dependent variable (Table 2.5).

The final model contained two main effects: 1) cigarette smoking at T1

(the control variable); 2) an interactive variable containing the following factors:

stress concerning physical appearance, hostility, family members and friends

who smoke, self-confidence, current alcohol usage, and internalized spirituality.

This model was highly predictive (Multiple R = .903; Multiple R-SQ = .815; F-ratio

= 105.97; p= .000).

53

Table 2.5 indicates the direction of the relationships between the factors in the

interactive variable and cigarette smoking. Kass and his colleagues found that family

and friends who smoke, hostility, and self-confidence are risk factors for cigarette

smoking. (The directions of these correlations were derived from trends observed

during the initial exploratory regression analyses.) In addition, stress concerning

physical appearance predicted increases in cigarette smoking. The primary factor

associated with reductions in cigarette smoking was internalized spirituality. (Moderate

alcohol use, associated with relaxation, was also associated with lower levels of

cigarette smoking. This finding was particularly reasonable given the age of the sample

cohort.) Thus, internalized spirituality buffered the effects of stress concerning physical

appearance, hostility, and prevalence of friends and family who smoke, thereby serving

as a significant protective factor against cigarette smoking.

Finally, in an exploratory study conducted with colleagues at the Addictions

Research Center, National Institute of Drug Abuse, Kass and colleagues found

internalized spirituality associated with decreased intent to drink alcohol among

recovering alcoholics (Arias, Douglas, Singleton, & Kass, 1994). This study of 125

recovering adult alcoholics also associated internalized spirituality with decreased

dysphoria, decreased hostility, and increased levels of happiness.

While the studies reported in this section must be considered exploratory, they

provide sound evidence that internalized spirituality can be a prevention resource by

contributing to reductions in health-risk behaviors. Further, though not comprehensive,

these studies lend support to Kass’ proposed prevention model linking spirituality with

54

health-promoting behaviors. In this two-step model, internalized spirituality contributes

to a resilient worldview. In turn, a resilient worldview contributes to reductions in health

risk behaviors.

c. Reductions in stress-related medical symptoms

When medical symptoms are caused or aggravated by the stress response, it is

reasonable to hypothesize that internalized spirituality—in conjunction with the

development of stress-reducing behavioral skills—can serve as resource contributing to

the reduction of these symptoms. In the study of behavioral medicine outpatients

reported above, Kass and his colleagues found internalized spirituality associated with

increases in Life Purpose and Satisfaction (Kass et al., 1991b). Using multiple

regression analysis, they also found internalized spirituality associated with reductions

in the frequency of stress related medical symptoms (Table 2.3).

Changes in the average frequency of symptoms were further analyzed by

dividing the outpatients into two groups: those who scored above and below the mean

group score on the INSPIRIT. An analysis of co-variance adjusting for differences

linked with demographic factors (age, gender, education) continued to show a

significant difference (p < .0034) between the two groups. Those scoring low on the

INSPIRIT showed a very slight increase in average frequency of symptoms (adjusted

mean change = .110), while those scoring high on the INSPIRIT showed a moderate

decrease (adjusted mean change = -.786).

55

In addition, they compared the INSPIRIT data to data from the “Belief in God”

question. Multiple regression analyses, controlling for demographic data, found that

"belief in God" was not significantly related to the average frequency of symptoms (ß =

-.167, p = .094).

Thus, the findings regarding frequency of medical symptoms parallel those

regarding Life Purpose. First, internalized spirituality served as a resource contributing

to reductions in these symptoms when the patient came to this treatment program with

an already developed sense of internalized spirituality. Second, though belief and God

and internalized spirituality are overlapping concepts, internalized spirituality is the more

efficacious predictor of health outcomes.

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V. Normative Data

A. Conceptual Approach

The use of normative data has advantages and disadvantages. Quite often, the

interpretation of an individual’s raw score on an assessment scale is nearly impossible

without a sense of comparison to groups of similar people. Respondents, themselves,

often want to know how their scores “compare with others.” Thus, it is almost inevitable

that some degree of normative data will be developed for a widely used assessment

scale.

Despite these necessary benefits, normative scores can be problematic. First,

“normative” scores are often misinterpreted to mean “normal” scores. In many

instances, however, and particularly in relationship to concepts like spirituality and

resilience, “what most people score” may not necessarily be a “healthy” or a “normal”

score. Precisely because we live in a society whose educational and medical systems

do not place sufficient focus on the development of psychological resilience and

emotional intelligence, it is not clear that normative data for the IPPA represents

“normalcy.” Similarly, because we live in a society that does not teach or support the

development of spiritual intelligence, it is not clear that normative scores presently

available for the INSPIRIT scale represent a “healthy” level of internalized spirituality.

For these reasons, Kass has been reluctant to replace raw score data from these

questionnaires with normative scales. Rather, Kass has chosen to emphasize the use

57

of raw score data and to provide sufficient normative information to allow the

respondent or professional a reasonably clear comparison with other individuals. The

SRA Scoring and Interpretation Instructions provide normative mean scores for each

questionnaire, as well as normative data regarding one standard deviation. Because

one standard deviation on each side of the mean comprises 68% of the variance in a

population sample, this data comprises a broad “normative range” without placing an

inordinate amount of attention on the process of comparison. This degree of normative

data allows individuals to place themselves into one of several broad and meaningful

categories:

 

 

Average Score

X

Lower Middle Upper Middle

34% 34%

Y-1 Y-2

Lowest 16% Highest 16%

58

Z-1 Z-2

 

 

X represents the average, mean score. Y-variables represent one standard deviation to either

side of the mean. Z-variables represent the absolute lowest and highest scores that an individual

can achieve. Thus,

 

 

If the score is between… Then the score is in the…

Z-2 and Y-2 Highest 16%

Y-2 and X Upper Middle 34%

X and Y-1 Lower Middle 34%

Y-1 and Z-1 Lowest 16%

 

B. Data for the IPPA

1. Placing the Raw Score in an Interpretive Context

59

The lowest possible score on the IPPA is 1.00. The highest possible score is

7.00. The mid-point of the IPPA is 4.00. A useful interpretive context is established by

dividing this variance into 4 equal quartiles.

 

Low = 1.00 – 2.49

Medium Low = 2.50 – 4.00

Medium High = 4.01 – 5.50

High = 5.51 – 7.00

 

The raw score can now be further compared to normative data.

2. Normative Scores

Norms for the IPPA were developed using a sample of 1,029 adult employees at

a corporate center in the western United States (Kass, 1998b, Zuttermeister, 1992 #72).

The sample was composed of 554 males and 475 females. The scores for the women

(Mean = 4.800; SD = .940) were quite similar to those for the men (Mean = 5.086; SD

= .878). This similarity allows the use of normative data for men and women together,

rather than the development of separate norms for each.

60

The mean score for the entire group was 4.953. This number is rounded off to

4.95 for use in the self-test scoring and interpretive instructions. The standard deviation

for this sample was .920. Thus, one standard deviation below the mean is 4.03. One

standard deviation above the mean is 5.87. Therefore, 68% of the respondents in this

sample scored between 4.03 and 5.87, with the average score being 4.95.

In summary:  

Those who scored… Were in the…

Above 5.87 Upper 16%

Between 5.87 and 4.95 Upper Middle 34%

Between 4.95 and 4.03 Lower Middle 34%

Below 4.03 Lower 16%

 

C. Data for the INSPIRIT

1. Placing the Raw Score in an Interpretive Context

The INSPIRIT scale has 7 questions. Each question can be scored 1, 2, 3, or 4. The

lowest possible score on the INSPIRIT is 7. The highest possible score is 28. A useful

interpretive context is established by dividing this variance into 4 quartiles.

Score Interpretive

Descriptor

Minimum Score in Maximum Score in

61

Range Corresponds

To This Pattern

Range Corresponds

To This Pattern:

7 – 10 LOW Score on 7 questions:

1

Score on 4 questions:

1

Score on 3 questions:

2

11 - 17 MEDIUM

LOW

Score on 4 questions:

2

Score on 3 questions:

1

Score on 4 questions:

2

Score on 3 questions:

3

18 - 24 MEDIUM

HIGH

Score on 4 questions:

3

Score on 3 questions:

2

Score on 4 questions:

3

Score on 3 questions:

4

25 – 28 HIGH Score on 4 questions:

4

Score on 3 questions:

3

Score on 7 questions:

4

 

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In essence, a low score can be equated with scores that are predominantly “1.” A

medium low score can be equated with scores that are predominantly “2.” A medium

high score can be equated with scores that are predominantly “3.” Finally, a high score

can be equated with scores that are predominantly “4.”

This raw score can now be further compared to normative data.

2. Normative Scores

Norms for the INSPIRIT were developed through a complex analysis of five data

sets. These samples were composed of 735 participants in a magazine survey (Kass &

Kass, 2000), 371 medical surgery outpatients and family members (VandeCreek et al.,

1995), 83 outpatients in a behavioral medicine program (Kass et al., 1991b), 126 adult

students at a divinity school ( et al., 1999), and 54 first year undergraduates (Kass et al.,

2000a). Five different samples provided the opportunity to analyze INSPIRIT with a

diverse range of populations. However, the analysis of these scores made it clear that

none of these scores can be considered fully “normative.” As a consequence, we

developed an analytic procedure to designate a putative mean score that best

represented the central tendency of these population samples. Similarly, we have

designated a number as the putative standard deviation that best represents the central

tendency of the variance within these samples. While this procedure has not been

wholly satisfactory, and while we hope to test a sample in the future that seems

sufficiently normative, the logic leading to the designation of these putative scores

seems reasonable.

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In ascending order, the mean scores for the five samples were:

First-year undergraduates 19.04

Behavioral Medicine Outpatients 19.60

Surgical Outpatients and Family Members 20.79

Divinity School Students 22.61

Health Magazine Respondents 23.31

While the variance between the mean scores of these samples is not extreme, it is

sufficiently large to require thoughtful designation of a putative standardized mean

score. In addition, it was not reasonable simply to give these samples equal weight and

to create an average among them, though this is an approximate description of the

method we chose. With the lowest mean score, we considered the undergraduates a

group where little exploration of spirituality has taken place. We considered their mean

(19.04) to represent a minimum range of the central tendency. With the highest mean

scores, we considered the divinity school students and the health magazine

respondents the groups where the most spiritual exploration has taken place. We

averaged their scores and considered this average mean score (22.96) to represent a

maximum range of the central tendency. With their scores in the middle range, we

considered the two outpatient populations groups most close to the central tendency.

Additionally, we considered these groups likely to include the greatest variance in

spiritual exploration, ranging from individuals who have engaged in a considerable

amount to individuals to individuals who have engaged in a negligible amount. This

assumption was supported by the fact that these two samples contain the largest

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standard deviations. We averaged the mean scores of these two samples to represent

the middle value in the central tendency (20.195). We then averaged the high, middle,

and low values that we had generated and considered (20.73) it to best represent the

central tendency of the INSPIRIT. For simplicity of presentation, we have rounded this

figure off a negligible amount to 20.5 for use in the self-test interpretive guide as the

average score on the INSPIRIT.

The determination of the standard deviation followed a similar process. In

ascending order, these figures were:

Divinity students 4.06

Undergraduates 4.20

Magazine respondents 4.34

Surgical outpatients 5.18

Behavioral Medicine outpatients 5.81

It is interesting to note that the two samples with the highest mean score (Divinity

students and magazine respondents) and the sample with the lowest mean score

(undergraduates) had the smallest internal variance, indicating greater homogeneity

within these samples. This lent credence to the interpretation that many of the divinity

students and magazine respondents had engaged in spiritual exploration. In addition, it

supported the likelihood that the undergraduates, as a group, had not engaged in very

much spiritual exploration. With the largest standard deviations, the outpatient samples

appear to contain the greatest variance in internalized spirituality, with a greater mixture

65

of those who have, and who have not, explored their own spirituality. We averaged the

standard deviations of the outpatient groups (5.495) and considered them, once again,

to represent the middle ground of the samples. We averaged the standard deviations of

the divinity students and magazine respondents (4.2) and considered them to represent

a more homogeneous high group. We used the standard deviation of the

undergraduates (4.2) and considered them to represent a more homogeneous low

group. We then averaged these middle, high, and low numbers (4.63) and considered

this number to represent the central tendency of the standard deviations. For simplicity

of presentation, we have rounded this figure off a negligible amount to 4.5 for use in the

interpretive guide.

Thus, the interpretive guide describes the average score on the INSPIRIT to be 20.5, with

most people’s scores ranging between 16 and 25.  

Those who scored… Were in the…

Above 25 Upper 16%

Between 20.5 and 25 Upper Middle 34%

Between 16 and 20.5 Lower Middle 34%

Below 16 Lower 16%

VI. Guidelines for Administration of the SRA

A. Conceptual Approach: Building Collaborative Dialogue

66

The Spirituality and Resilience Assessment Packet can be administered to

individuals or groups. It is administered in a Self-Test Format that enables an individual

to score and interpret the results privately. Spirituality and psychological resilience are

often experienced as very “personal” domains, particularly when individuals have not

had experience discussing these aspects of their lives with human service professionals

or peers. The Self-Test format of the SRA allows individuals to retain a strong degree

of control over the information generated by this assessment packet, and provides them

with the freedom to decide whether or not they wish to discuss their results with a

member of the clergy or a human service professional.

While this procedure might appear to minimize the likelihood that an individual

will discuss these results with professionals or peers, the opposite situation appears to

be the case. When this assessment process is presented to individuals as a vehicle for

collaborative dialogue and self-empowerment, the control of information retained by the

individual contributes to the formation of trust in the helping relationship. Similarly, while

this procedure might appear to increase the likelihood that individuals would report

inaccurate or “socially desirable” scores, the opposite situation also appears to be the

case. When individuals are encouraged to begin the process of self-assessment by

being honest with themselves, prior to discussion with others, the rapidity with which

individuals move from a stance of self-protection or defensiveness toward accurate and

honest disclosure is increased.

B. Competency Requirements for Professionals

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1. Basic Counseling and Referral Skills

For use in psychoeducational and psychospiritual interventions, the SRA is best

administered by a professional who has received training in basic counseling skills. The

examination of attitudes and life domains as personal as psychological resilience and

spirituality can stimulate anxiety or other uncomfortable emotions. These concerns and

emotions may require psychological and spiritual support. The administrator of the SRA

should be able to observe signs that an individual is withdrawing, or has withdrawn,

from contact with others regarding their psychospiritual difficulties. In addition, the

administrator should have interpersonal skills with which to intervene directly and

respectfully when an individual is showing signs of a psychospiritual crisis. If

necessary, the professional must be prepared to provide spiritual and emotional

counseling, or to provide referral to trained professionals for such counseling.

2. Training in Multicultural Competencies

The formation of trust is a key element in the successful exploration of

psychospiritual issues. Trust, however, is strongly affected by the dynamics of power

(perceived and actual) within the helping relationship (Gawelek, Kass, Langley, Llera, &

Roffman, 1994). In turn, the dynamics of power in the helping relationship are strongly

related to differences in cultural identity (religious background, race, ethnicity, gender,

sexual orientation, and physical ability) between the professional and the client.

Consequently, a professional’s inability to recognize the effects of cultural differences

on power dynamics within the helping relationship can undermine the formation of trust.

68

As a result, professional preparation for administration of the SRA must include the

acquisition of multicultural competencies.

C. Practical Steps for Preparation

1. Step One: Take the Test Yourself

An individual who has not used the SRA as a tool for his or her own growth and

development should not administer the SRA to others. The first step in preparation to

administer this instrument is to become thoroughly familiar with the process of self-

examination created by the SRA. For the purposes of professional preparation, this

self-examination process must include in-depth explorations of the professional’s

psychological resilience, the role that internalized spirituality plays in her or his

resilience, and the formative events that have contributed to the professional’s faith

development.

2. Step Two: Be Thoroughly Familiar with the Concepts

Introductory pages precede the two questionnaires in the SRA. These pages

explain the questionnaire’s purpose and key concepts. These introductory pages can

be used by the professional as a script for the presentation of this assessment process.

It is recommended that the professional be highly familiar with these introductory pages

prior to administration of the SRA. The professional should be prepared to discuss

these concepts with a respondent without needing to refer to these scripted pages. The

69

discussions in the following section may help professionals to manage some of the

more difficult and challenging concepts.

3. Step Three: Anticipate Challenging Issues

Two challenging issues arise fairly consistently during administration of the SRA.

First, respondents often need to discuss the language that will be used to denote “God.”

Second, individuals often need to discuss the meaning of the word “spirituality.” The

administrator of the SRA should be prepared to respond to both issues. The following

guidelines can help the professional to prepare for these discussions.

a. Language to denote “God”

Particularly within multifaith organizations and contexts, the use of sufficiently

inclusive language to denote “God” is difficult. The language denoting God in the SRA

has been chosen carefully to respectfully include conceptualizations of the sacred

aspect of life from a wide range of cultural and religious traditions. Thus, the packet

uses the word God to affirmatively include Christian, Jewish, Muslim, and Hindu

respondents who often conceptualize the sacred aspect of life in a personal form. At

the same time, the SRA employs the terms Higher Power, Spirit of Life, spiritual

core, and the sacred aspect of life to affirmatively include respondents who

conceptualize the transcendent reality in a non-personal form. Such respondents can

include practitioners of Buddhism and Taoism, Native American religions, and other

religious traditions of indigenous peoples. These respondents can also include

70

practitioners of feminist and earth-based forms of spirituality (Celtic and Wiccan

traditions) that provide a useful critique of gender-bias in descriptors of the sacred.

Clear theological differences exist between, and among, these religious

traditions. The intent underlying the development of the INSPIRIT is not to overlook

these substantive differences. At the same time, the intent underlying the development

of the INSPIRIT is not to engage in debate regarding these differences. Rather, the

INSPIRIT seeks to articulate two fundamental concepts of spirituality shared by these

faith traditions—despite their differences. These concepts are reflected in the two

aspects of spirituality measured by the INSPIRIT, the experiential aspect and the

relational aspect.

The experiential aspect of spirituality:

Each of our faith traditions recognizes the existence of a transcendent, sacred

aspect of life. Whether our traditions describe God in personal language (i.e.

Jesus, Jehovah, Allah) or non-personal language (i.e. the Spirit of Life, the Tao),

the sacred aspect of life is understood to be “the ground of all being.” In addition,

each of our faith traditions recognizes that the presence of the sacred aspect of

life can be felt and experienced by the individual. Such an experience is more

than an intellectual belief in God. It is an inner knowing, based on personal

experience. The INSPIRIT seeks to find out whether the individual has had such

an experience irrespective of their particular religious affiliation.

The relational aspect of spirituality:

71

Our faith traditions share the principle that a relationship exists between the

individual and the sacred aspect of life. When God is pictured in personal terms,

this connection is conceptualized as though it were a person-to-person

relationship. When God is pictured as the Spirit of Life, this connection is

conceptualized as a fundamental unity in which God is the core of each person

and all life. In addition, our traditions teach that the ability of an individual to live

in a health-promoting and ethical manner proceeds from that individual’s

recognition and nurturing of this relationship. Thus, the “closer” that we feel to

God, the more likely we are to be able to translate our experience of God’s

existence into positive actions in our lives. The INSPIRIT seeks to find out how

close an individual feels to God, irrespective of a person’s specific God-image.

 

Consequently, despite substantial doctrinal differences within and between our faith

traditions, the INSPIRIT taps two aspects of spirituality that are shared by our faith

traditions1[1].

A respondent who has become comfortable with such differences, and who is

equally comfortable recognizing the underlying similarities between our faith traditions,

rarely expresses difficulty with the language denoting God in the INSPIRIT.

1 

?[1] Tolerance for religious differences should never be equated with tolerance for immoral or unethical activities. It should be recognized that some leaders or groups within every religious tradition have sanctioned unethical uses of power.

72

However, a respondent who is less comfortable with such differences, and who

has not yet recognized the underlying similarities among our faith traditions, is likely to

have some negative reactions to the inclusive language of the INSPIRIT. It is helpful for

the professional to be prepared to respond to these negative reactions in a non-

defensive and acceptant manner.

For example, it can be anticipated that some Christians from more traditional

backgrounds may not be fully comfortable with language referring to God as “the sacred

aspect of life.” In order to complete the INSPIRIT, they may wish to cross out the

impersonal terms denoting God that they find unacceptable in order to represent the

nature of their own belief system. While we would hope that the use of the INSPIRIT

would eventually lead individuals to more inclusive perspectives, the choice to cross out

(or change) some of the language denoting God is acceptable.

In a similar vein, some women who have been wounded emotionally or physically

by misuses of power within patriarchal religious structures, are not comfortable with the

use of the word “God” because it traditionally denotes a male figure. They may wish to

cross out this word, or to replace it with a female-focused image like “Goddess” or

“Mother,” or with a gender-free term like “Great Spirit.” Here, too, it is useful for the

professional to support respondents in choices that allow them to define the sacred

aspect of life in their own terms. Such changes will enhance the ability of the

respondent to utilize the INSPIRIT.

73

In addition, a respondent’s need to make such changes often creates a doorway

for dialogue between the respondent and the professional. Rather than treating such

negative reactions as problematic, it is useful for the professional to treat these

interchanges as diagnostic of issues that could be discussed. Specifically, these

interchanges can be treated as opportunities to understand more about the spiritual life

and history of the respondent. Thus, one of the most useful ways to respond to these

critical reactions is to learn more about the factors that have led the individual to these

strongly felt responses.

b. Defining “spirituality.”

As we have seen in the conceptual discussion in Section III-B, “religiosity” and

“spirituality” are overlapping concepts. Religiosity generally refers to participation in an

organized religion. Spirituality, on the other hand, refers to the quality of the relationship

that an individual experiences with the sacred aspect of life. As a consequence, an

individual with a deeply internalized sense of spirituality will often participate in an

organized religion. However, the fact that an individual participates in an organized

religion is not equivalent to having a deeply internalized sense of spirituality. Further,

some individuals with a deeply internalized sense of spirituality have not found a

personally satisfying organized faith community.

Particularly during the early stages of spiritual exploration, when a person is

beginning to seek an internalized form of spirituality, it is possible—and in some cases

highly likely--that this person will experience a significant difference between

74

“spirituality” and “religiosity.” Whenever an individual has experienced organized

religion as an external imposition of beliefs, rather than as a vehicle for the personal

development of internalized spirituality, the individual’s need for such an authenticating

process often draws this person away from the organized religion in which he or she

was educated. Thus, we now find in our society a substantial number of individuals who

state that they are “spiritual” but not “religious.” At times, it is tempting for the

professionals to treat such statements as superficial. However, it is useful to hear the

message beneath this statement. This unstated message often indicates that a person

is in the early stages of seeking an internalized form of spirituality. Rather than treating

such a statement as superficial, it is more useful to treat this statement as a signal that

a person is in the midst of—or in need of—a process of growth that will lead to a

deepened quality of relationship with the sacred aspect of life.

We often think of spirituality as a static quality that some individuals possess,

whereas other individuals do not possess it. However, the differentiation that we are

developing between internalized spirituality and religiosity helps to emphasize that

spirituality is a dynamic, developmental process. This process includes a continuum of

depth and experience. Similarly, it includes a process of learning. An emphasis on

spirituality as a process of learning provides an entrance point for individuals who wish

to examine this unexplored aspect of their lives. As a consequence, Kass defines

spirituality, initially, in the following way:

Spirituality is a developmental process through which individuals learn to enhance

the quality of their relationship with the sacred aspect of life (Kass, 1998c).

75

This statement can serve as a useful, initial working definition of “spirituality.”

However, this definition soon needs to be expanded to include an individual’s

actions in the world. Each of our faith traditions teaches that internalized spirituality will

—and should--manifest itself in visible behavior. First, this behavior includes the

courage and strength to treat the needs of others as having equal importance with one’s

own. Second, this behavior includes the ability to respond to the conditions of life with

several important qualities: loving kindness, inner peace, a sense of purpose, and an

empowered self. Thus, we can expand our definition of spirituality to the following:

 

Spirituality is a developmental process in which individuals learn to

enhance the quality of their relationships with the sacred aspect of life, and

with others.

In addition, spirituality is a developmental process in which individuals learn to

develop skills to face the conditions of their lives with the following qualities: an

empowered self, a sense of purpose, loving kindness, inner peace, and the courage to

place the needs of others on an equal footing with their own (Kass, 1998c)2[2].

2[2] It is useful to note that many of these behavioral qualities are measured by the Inventory of Positive Psychological Attitudes. As noted in the interpretation guidelines of the SRA, some individuals score HIGH on the INSPIRIT and LOW on the IPPA. This indicates that they are not yet learning to integrate their experiences of the spiritual core into health-promoting and pro-social behaviors. This pattern seems to occur often among individuals who use spirituality as a form of psychological escape, as well as among authoritarian religious groups that demand an inordinate degree of social conformity. A recognition of this disjuncture between INSPIRIT and IPPA scores can contribute to an individual’s spiritual maturation.

76

If we look carefully at this definition, we see that an essential feature of

internalized spirituality is “connection.” The development of internalized spirituality

produces increased connection to the sacred aspect of life, to others, and to self (Kass,

1998c). This emphasis on “connection” is central to an understanding of the practices

and teachings of our spiritual traditions. Where mechanistic philosophies focus on an

individual’s existential isolation, thereby promoting behaviors and attitudes that

emphasize “separateness,” the world’s spiritual traditions focus on the human capacity,

and need, for connective awareness (Kass, 1998c). Here, too, our spiritual traditions

emphasize a developmental, learning process. On the one hand, internalized

spirituality leads to connective awareness. On the other hand, connective awareness

leads to internalized spirituality. Each builds upon the other, as the individual—and

communities—gradually develop an increasingly deep sense of connection to the

sacred aspect of life, to others, and to self.

It is important to recognize, however, that the developmental path through which

connective awareness is acquired is different for each individual. Nor does the

development of internalized spirituality always begin with a sense of connection to God.

For some people, internalized spirituality begins with a sense of connection to others.

For some people, it begins with a sense of connection to the creative self. For still

others, internalized spirituality begins with a sense of connection to nature. (This is not

surprising. The contemplation of nature’s beauty is one of the most direct vehicles for

experiencing the sacred aspect of life.)

77

An understanding of these developmental pathways emphasizes that the process

through which spirituality becomes internalized does not necessarily take place in a

house of worship. Rather, it begins to develop within the web of a person’s life (their

creative activities, their relationships, their explorations of nature) as well as within more

formal practices like prayer and meditation.

As a consequence, the SRA utilizes an inclusive perspective that values

evidence of internalized spirituality in each aspect of a person’s life. For this reason, the

introduction to the INSPIRIT includes the following discussion:

 

“The essence of spirituality is not whether—or how often—you attend religious services. Rather, the essence of spirituality is the way that you experience life. Spirituality is the experience of connection to the sacred aspect of life, the spirit of life.

For some of us, the experience of the spirit of life grows from a sense of connection to our own inner, creative core.  

For some, this experience grows from a sense of connection to other people.  

For some, this experience grows from a sense of connection to nature.

For some, this experience grows from a sense of connection to a power that is greater than our selves: the ground of being, God.  

Over time, an exploration of your spirituality can lead you to new experiences in each of these areas. For these experiences share a common thread: recognition of the spiritual core that creates and sustains the fabric of life.”

 

This discussion articulates many different avenues through which individuals

begin to experience and explore their own spirituality. Through such an introduction,

the SRA seeks to give individuals an opportunity to recognize the seeds of their own

78

spirituality. It is useful and important for the professional to recognize and value the

many areas of life where internalized spirituality may first begin to flourish.

In a similar vein, the spiritual experience checklist (Question 7) on the INSPIRIT

articulates a continuum of experiences through which individuals can recognize the

presence of the sacred aspect of life. While not meant to be comprehensive (an

individual can include a different experience of his or her own), this continuum begins

with comparatively ordinary, daily experiences and gradually moves to less ordinary

experiences:

An experience of profound inner peace An overwhelming experience of love A feeling of unity with the earth and all living beings An experience of complete joy and ecstasy Meeting or listening to a spiritual teacher or master An experience of God's energy or presence An experience of a great spiritual figure (e.g. Jesus, Mary, Elijah, Buddha)  A healing of your body or mind (or witnessed such a healing)  A miraculous (or not normally occurring) event An experience of angels or guiding spirits An experience of communication with someone who has died An experience with near death or life after death

 

79

This continuum allows an individual to begin to conceptualize spirituality as a

developmental process, and to emphasize the many highly ordinary, yet extremely

profound moments of spirituality which individuals often experience. By helping

individuals grow more connected to themselves—and by helping them become more

aware of, and more responsive to—the “moments of spirituality” that occur throughout

their lives, we enable individuals to recognize their own spirituality—and their own

spiritual capacities. An individual’s recognition of his of her own capacity for spiritual

awareness is key to helping that person embark upon this important learning process.

Unfortunately, most human service professionals, educators, and clergy have not

learned to utilize this developmental approach to spirituality. The recognition of the

significant role that internalized spirituality can play in human maturation is still minimal

within the fields psychology, medicine, and education. At the same time, training

curricula for clergy often do not help to correct this imbalance. Quite ironically, such

training often places minimal emphasis on clergy’s role as facilitators of developmental

learning leading to internalized spirituality. This minimization separates our traditional

religious practices—like prayer—from the dynamic developmental process to which they

should be connected, severely reducing the likelihood that individuals and communities

will develop internalized forms of spirituality. As a consequence, our society has not

learned to utilize this unique resource for human maturation that is particularly vital to

the well being of young adults and youth, as well to adults in the midst of crisis or stress

(Kass, 1995; Kass & Douglas, 2000).

80

It should be evident that this discussion of spirituality as a developmental process

is not an argument leading away from traditional religious practices. Our research on

internalized spirituality suggests that the outcome of this developmental process is an

integration of religious practices into individual and family life. Thus, in their most

developed forms, spirituality and religiosity once again become synonymous.

4. Formal and Informal Applications of the SRA

The preceding discussion on the meaning of “spirituality” suggests two different

ways to administer and use the SRA. On the one hand, the professional can utilize the

SRA as a formal assessment tool. On the other hand, the professional can utilize the

SRA informally to generate discussion and exploration.

When administered formally, the professional will introduce the purpose of the

SRA and ask the respondent to complete the questionnaire. While questions and

limited dialogue are appropriate, these would be kept to a minimum. When the

respondent has completed the scoring and interpretive process, the professional (or the

respondent) can initiate dialogue regarding the respondent’s results, or any issues

generated by completion of the SRA.

When administered informally, the SRA can be used as a vehicle for a structured

conversation between the professional and the respondent. For example, the

professional and the respondent might read through the SRA together and discuss each

item. In other instances, the professional might use the SRA as a guideline for dialogue

without actually giving the assessment packet to the client.

81

Such a dialogic approach, of course, can lead to substantive issues regarding the

respondent’s emotional and spiritual life. Thus, a less formal, dialogic approach will

require a greater commitment of time. Structured conversations using the SRA

generally require between 1 ½ and 2 hours.

Although this informal approach will appeal to many professionals, it should be

noted that this dialogic approach may be too revealing of personal issues for individuals

who are not prepared for emotional disclosure at this level of depth. In many cases, it is

prudent to begin use of the SRA with an individual in a manner that provides them with

the greatest amount of privacy and control over this very personal information.

With either approach, it is helpful to emphasize to the respondent that the

purpose of this assessment packet is not to give information to the professional that will

be used “on” the client. Rather, the purpose of this assessment packet is to generate

information that the professional and the respondent can use together collaboratively to

enable the respondent to develop internal resources to handle stress and crisis more

constructively.

82

VII. Scoring and Interpretation of the SRA

Instructions for scoring the SRA are provided in the assessment packet and do

not require further explanation in this manual. The professional can refer to Section V

(Normative Data) to further understand the conceptual development and the meaning of

a respondent’s scores.

Similarly, basic guidelines for the interpretation of a respondent’s scores are

provided in the assessment packet. These interpretive guidelines will be self-evident to

clergy, human service professionals, or educators and can provide the basis for more

extensive discussions between the professional and the respondent.

83

Table 1.1

 

Multidimensional Factor Structure of the IPPA-30

Common Factor Analysis with Varimax Rotation1

 

LPS

Scale

  Factor 1 Factor 2

  Energy level is high .403 .229

  Life seems vibrant .724 .161

  Daily activities satisfy .608 .135

  Every day is new and different .617 .136

  Purpose to life .459 .188

  My life has been productive .607 .182

  My work is valuable .588 .119

  I do not wish I were different .506 .4022

  Clearly defined goals .479 .245

  Continue to feel positive about life when

sad

.423 .5022

  My life feels worthwhile .700 .292

  Present life satisfies me .739 .259

  Feel joy in my heart .612 .222

  Do not feel trapped by my life .619 .315

84

circumstances

  No regrets regarding my past .451 .335

  Feel loved .507 .311

  Hopeful about solving my problems .561 .331

       

SCDS      

  Calm during pressure .137 .537

  React to problems with no frustration .225 .648

  No anxiety during stress .160 .545

  Can like myself after a mistake .286 .464

  No catastrophic worries during stress

situations

.140 .555

  Can concentrate during stress .153 .528

  No fear during stressful circumstances .159 .575

  Can stand up for myself when I need .239 .431

  Feel adequate during difficult situations .368 .520

  Able to respond positively during

difficulties

.4132 .492

  Can relax during times of stress .369 .391

  Remain calm in frightening situations .099 .529

  Worry about the future during stress .286 .461

       

  Eigenvalues 6.430 4.770

85

     

  Total Variance Explained 21.43% 15.90%

1 Confirmatory analysis using the 30 items of the IPPA. No restrictions on number of factors.

2 Loading above .4 on both factors.

86

Table 1.2

 

Construct Validity of the IPPA

 

Correlations between IPPA Scales and Other Attitudinal Measures

 

  Inventory of Positive Psychological Attitudes        p-value  SCDS LPS CLS-Total           McNair Bi-Polar Profile of Mood States (POMS)1

       

          Composed/Anxious .60 .56 .63 <.0001 Agreeable/Hostile .37 .47 .46 <.0001 Elated/Depressed .55 .65 .66 <.0001 Confident/Unsure .65 .67 .72 <.0001 Energetic/Tired .38 .49 .48 <.0001 Clearheaded/Confused .51 .56 .58 <.0001         Rosenberg Self-Esteem Scale1 .67 .76 .79 <.0001         Bradburn Affect Balance Scale1 .55 .65 .66 <.0001         UCLA Loneliness Scale1 -.50 -.64 -.63 <.0001         Derogatis Psychiatric Symptom Checklist (SCL- 90-R)2

       

          Hostility -.41 -.35 -.41 <.0001          Depression -.57 -.60 -.64 <.0001          Anxiety -.54 -.40 -.50 <.0001          Global Severity Index -.57 -.52 -.59 <.0001

 1 (Kass et al., 1991a)

87

2 (Zuttermeister et al., 1992)

88

Table 2.1

 

INSPIRIT Factor Structure

  

Kass Study 1(1)

N = 83

VandeCreek(2)

N = 347

Kass Study 2(3)

N = 735

 

 

.809

 

.620

 

.799

Strongly spiritual or religious

 

.816

 

.572

 

.774

Time spent on spiritual practices

 

.848

 

.163

 

.715

Close to a powerful spiritual force

       .688 .541 .823 Close to God        

.793

 

.548

 

.788

Experience of God’s existence

 

.836

 

.510

 

.715

Agree that “God dwells within you”

 

.765

 

.503

 

.699

Spiritual experience(s) leading to conviction of God’s existence

       4.42 3.46 4.05 Eigenvalues       63.20 49.40 57.81 Variance Explained

(Percent)

 

89

Table 2.2

 

Experiences of the Spiritual Core and Length of Time Meditating

 

Analysis of Covariance

Controlling for Demographic Data: Age, Gender, and Educational Level

 

Source df SS MSS F P

 

Between

Subjects 70 49.9166

 

Covariates 2 0.1281 0.0640 0.098 0.9076

 

Age 1 0.0194 0.0194 0.030 0.8640

 

Education 1 0.1087 0.1087 0.166 0.6850

 

Time Medit 1 2.9669 2.9669 4.532 0.0371

 

Gender 1 4.0930 4.0930 6.252 0.0149

90

 

Time X Gend 1 0.1761 0.1761 0.269 0.6057

 

Subj w Groups 65 42.5525 0.6547

 

 

Factors N Adjusted Means

 

Combined 71 2.8244

 

Time Medit

 

<1 month 51 2.6963

 

>1 month 20 3.1513

 

Gender

 

Male 24 2.4480

 

Female 47 3.0167

 

91

Table 2.3

 

Relationships between Internalized Spirituality, Resilience, and Stress-Related Medical Symptoms among Outpatients

 

Multiple Regression Analyses with Controls for Demographic Data and Health Status at Time 1

Dependent Variable

Independent Variables

Beta p-Value Adjusted

R-Square         Life Purpose and Satisfaction (T2)

 

Life Purpose (T1)

INSPIRIT

AGE

.83

.15

.10

.0000

.0235

.1303

 

 

 

 

.715Frequency of Stress-Related Medical Symptoms (T2)

Frequency (T1)

INSPIRIT

Gender

Education

.66

-.31

.17

.11

.0000

.0005

.1068

.3128

 

 

 

 

.469

 

92

Table 2.4

 

Relationship of INSPIRIT to Confidence in Life and Self (CLS) and Hostility

 

Multiple Regression Analyses

Divinity School Students (Female and Male)

 

DEP VAR

  IND VAR STD BETA COEF

 

P- VAR

MULT-R

MULT-R SQ

F-RATIO

P- MODEL

CLS Women INSPIRIT .278 .011            Mate -.274 .013                  .401 .161 7.005 .002  Men INSPIRIT .383 .010            School -.377 .012                  .548 .301 7.521 .002                                                                    Hostility Women CLS -.321 .003            INSPIRIT -.200 .054            Appear .267 .008            No Fun .207 .040            Age -.157 .113                  .600 .360 7.889 .000

 

93

Table 2.5

 

Predictive Model for Cigarette Smoking:

 

Multiple Regression Analysis with Cigarette Smoking at T3 as Dependent Variable1

 

CO-IND VAR Std Beta Coef

p-

var

Mult-R Mult-R Sq

F-

ratio

p-

model

             Variable 1 (Control Variable): .625 .000        Cigarette smoking at T1                         Variable 2 (Interactive Factors):

 

.329 .001        

Stress concerning physical appearance

(+ correlation2)

           

*             Hostility

(+ correlation2)

           

*             Family and friends who smoke

(+ correlation2)

           

*             Self-confidence (SC)

(+ correlation2)

           

*             Current alcohol usage

(- correlation2)

           

*             Internalized spirituality            

94

(- correlation2)                   .903 .815 105.974 .000             

1 Interactive stepwise multiple regression, controlling for cigarette smoking at T1.

2 Direction of regression coefficients for interactive factors, when considered as co-independent variables.

95

 

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Gold, P. W., Goodwin, F. K., & Chrousos, G. P. (1988b). Clinical and biochemical manifestations of depression: Relationship to the neurobiology of stress (part 2). New England Journal of Medicine, 319(7), 413-420.

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Hood, R., Jr. , Hall, J., Watson, P. J., & Biderman, M. (1979). Personality correlates of the report of mystical experiences. Psychological Reports, 43(3), 804-806.

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Jordan, J. V., Kaplan, A. G., Miller, J. B., Stiver, I. P., & Surrey, J. L. (1991). Women's growth in connection. New York: Guilford Press.

Kass, J. (1991a). Contributions of religious experience to psychological and physical well being: Research evidence and an explanatory model. The Caregiver (College of Chaplains), 8(4), 4-11.

Kass, J. (1991b). Integrating spirituality into personality theory and counseling practice. Paper presented at the American Counseling Association, 1991 Annual Meetings, Reno, Nevada.

Kass, J. (1995). Contributions of religious experience to psychological and physical well being: Research evidence and an explanatory model. In L. VandeCreek (Ed.), Spiritual needs and pastoral services: Readings in research (pp. 189-213). Decatur, Georgia: Journal of Pastoral Care Publications.

Kass, J. (1998a, May 22, 1998). Extending Rogers' process conception of personal development: The experience of the spiritual core as a phenomenological outgrowth of increases in internalized locus of evaluation. Paper presented at the Association for the Development of the Person-Centered Approach, 13th Annual Meeting, Wheaton College, Wheaton, MA.

Kass, J. (1998b). The Inventory of Positive Psychological Attitudes: Measuring attitudes which buffer stress and facilitate primary prevention. In C. Zalaquett & R. Wood (Eds.), Evaluating Stress: A Book of Resources (Vol. 2, pp. In publication). Lanham, MD: Scarecrow Press/University Press of America.

Kass, J. D., Burton, L., Knickles, R. M., Ferranti, L., Singleton, E. G., Gawelek, M. A., Davis, F., & Allen, E. (1999). Experiences of the sacred as a prevention resource in a stressful world: Relationships between experiences of the sacred, positive worldview, and health-risk attitudes among divinity students. Paper presented at the Society for the Scientific Study of Religion, 1999 Annual Meetings, Boston, MA.

Kass, J., Friedman, R., Leserman, J., Caudill, M., Zuttereister, P., & Benson, H. (1991a). An inventory of positive psychological attitudes with potential relevance to health outcomes. Behavioral Medicine, 17(3), 121-129.

Kass, J., Friedman, R., Leserman, J., Zuttermeister, P., & Benson, H. (1991b). Health outcomes and a new measure of spiritual experience. Journal for the Scientific Study of Religion, 30(2), 203-211.

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Education as Transformation: Religious Pluralism, Spirituality, and Higher Education, Wellesley College, Wellesley, MA.

Kass, J. D. (2000a). Internalized spirituality: A resource for resilience. Manuscript in preparation.

Kass, J. D. (2000b). Psychological resilience, cigarette smoking, and overeating: A study of healthy adults. Manuscript in preparation.

Kass, J. D., Burton, L., Knickles, R. M., Ferranti, L., Singleton, E. G., Gawelek, M. A., Davis, F., & Allen, E. (1999). Relationships between experiences of the sacred, positive wordview, and health risk attitudes among divinity students. Paper presented at the Society for the Scientific Study of Religion, 1999 Annual Conference.

Kass, J. D., Burton, L., Knickles, R. M., Ferranti, L., Singleton, E. G., Gawelek, M. A., Davis, F., & Allen, E. (2000a). Cigarette smoking in first-year college women: Gender-specific risk factors and protective resources. Psycho-Oncology, Accepted for publication.

Kass, J. D., Burton, L., Knickles, R. M., Ferranti, L., Singleton, E. G., Gawelek, M. A., Davis, F., & Allen, E. (2000b). A model for the development of resilience in adult university students: Internalized spirituality and positive worldview as protective resources. Submitted for publication.

Kass, J. D., & Douglas, T. (2000). Internalized spirituality as a protective resource for college students. Prevention Pipeline, Center for Substance Abuse Prevention (CSAP), June/July.

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APPENDIX

 

 

THE SPIRITUALITY AND RESILIENCEASSESSMENT PACKET

 

 

 

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==RESOURCES FOR RESILIENCE==

 

 

BUILDING A RESILIENT WORLDVIEW

THROUGH

SPIRITUALITY

 

 

 

 

Spirituality and Resilience Assessment Packet

Version 4.2

 

 

 

Behavioral Health Education Initiative

 

Jared D. Kass, Ph.D., LMHC

Lynn Kass, M.A., M.A.T., LMHC

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Co-Directors

 

 

Greenhouse, Inc.

46 Pearl St.

Cambridge, Massachusetts 02139

617-492-0050

 

 

2000, 1996, 1990, 1989 Jared D. Kass

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Part I: A Resilient Worldview

 

Difficulties, serious problems, and crises are an inescapable part of life.

 

The purpose of this packet is to help you strengthen important inner resources that will enable you to face a crisis or serious problem more effectively—either now or in the future.

 

Whether the difficulty you face is medical, emotional, or circumstantial…whether it confronts you or someone you love…whether it is taking place in your personal life, your family life, or your work life...your own inner resources strongly affect your ability to face a serious problem.

 

The most significant inner resource that you have is your own worldview--

your attitudes about life. If your worldview is resilient, you can respond to a crisis constructively.

 

A resilient worldview is characterized by feelings of Confidence in Life and Self. This means that, in times of crisis or stress, you feel confident…and connected to a sense of purpose in your life.

 

A resilient worldview is empowering. It helps you to:

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Mobilize your energies when you need to act.

 

Relax your body and mind when you need to rest.

 

Think for yourself when others do not know what is best for you.

 

Trust in others, and in life itself, when you have done all that you can.

 

 

The first questionnaire in this packet will help you determine how resilient your worldview is. You will probably learn that you already have many resilient attitudes. You will also learn, most likely, that some of your attitudes are not as resilient as they might be. By reviewing these results on your own, and with those who provide you with support, you can begin to build new strengths where they are lacking.

 

The first questionnaire is called The Inventory of Positive Psychological Attitudes (IPPA). After you complete it, follow the simple scoring instructions to interpret the results.

 

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INVENTORY OF POSITIVE PSYCHOLOGICAL ATTITUDES

SELF TEST VERSION

(IPPA-32R)

 

 

The following questions contain statements and their opposites. Notice that the statements extend from one extreme to the other. Where would you place yourself on this scale? Place a circle on the number that is most true for you at this time. Do not put your circles between numbers.

LIFE PURPOSE AND SATISFACTION:

 

 

very low 1 2 3 4 5 6 7 very high

 

2. As a whole, my life seems

 

dull 1 2 3 4 5 6 7 vibrant

 

3. My daily activities are

 

not a source of 1 2 3 4 5 6 7 a source of

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satisfaction satisfaction

 

4. I have come to expect that every day will be

 

exactly the same1 2 3 4 5 6 7 new and different

 

5. When I think deeply about life

 

I do not feel there is 1 2 3 4 5 6 7 I feel there is

any purpose to it a purpose to it

 

6. I feel that my life so far has

 

not been productive 1 2 3 4 5 6 7 been productive

 

7. I feel that the work* I am doing

 

is of no value1 2 3 4 5 6 7 is of great value

 

*The definition of work is not limited to income-producing jobs. It includes childcare, housework, studies, and volunteer services.

 

8. I wish I were different than who I am.

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agree strongly 1 2 3 4 5 6 7 disagree strongly

 

9. At this time, I have

 

no clearly defined 1 2 3 4 5 6 7 clearly defined

goals for my life goals for my life

 

10. When sad things happen to me or other people

 

I cannot feel 1 2 3 4 5 6 7 I continue to feel

positive about life positive about life

 

11. When I think about what I have done with my life, I feel

 

worthless 1 2 3 4 5 6 7 worthwhile

 

12. My present life

 

does not satisfy me 1 2 3 4 5 6 7 satisfies me

 

13. I feel joy in my heart

 

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never 1 2 3 4 5 6 7 all the time

 

14. I feel trapped by the circumstances of my life.

 

agree strongly 1 2 3 4 5 6 7 disagree strongly

 

15. When I think about my past

 

I feel many regrets 1 2 3 4 5 6 7 I feel no regrets

 

16. Deep inside myself

 

I do not feel loved 1 2 3 4 5 6 7 I feel loved

 

17. When I think about the problems that I have

 

I do not feel hopeful 1 2 3 4 5 6 7 I feel very hopeful

about solving them about solving them

 

 

SELF CONFIDENCE DURING STRESS:

 

1. When there is a great deal of pressure being placed on me

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I get tense 1 2 3 4 5 6 7 I remain calm

 

2. I react to problems and difficulties

 

with a great deal  1 2 3 4 5 6 7 with no

of frustration frustration

 

3. In a difficult situation, I am confident that I will receive

the help that I need.

 

disagree strongly 1 2 3 4 5 6 7 agree strongly

 

4. During stressful circumstances, I experience anxiety

 

all the time 1 2 3 4 5 6 7 never

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5. When I have made a mistake during a stressful situation

 

I feel extreme 1 2 3 4 5 6 7 I continue to

dislike for myself like myself

 

6. When a situation becomes difficult, I find myself worrying that something bad is going

to happen to me or those I love

 

all the time 1 2 3 4 5 6 7 never

 

7. In a stressful situation,

 

I cannot concentrate 1 2 3 4 5 6 7 I can concentrate

easily easily

 

8. During stressful circumstances, I am fearful

 

all the time 1 2 3 4 5 6 7 never

 

9. When I need to stand up for myself

 

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I cannot do it 1 2 3 4 5 6 7 I can do it quite easily

 

10. I feel less than adequate when I am in difficult situations.

 

agree strongly 1 2 3 4 5 6 7 disagree strongly

 

11. During times of stress, I feel isolated and alone.

 

agree strongly 1 2 3 4 5 6 7 disagree strongly

 

12. In really difficult situations

 

I feel unable to 1 2 3 4 5 6 7 I feel able to

respond in respond in

positive ways positiveways

 

13. When I need to relax during stressful times

 

I experience no peace-- 1 2 3 4 5 6 7 I experience peacefulness

only thoughts and worries free of thoughts and worries

14. When I am in a frightening situation

 

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I panic 1 2 3 4 5 6 7 I remain calm

 

15. During stressful times in my life, I worry about the future

 

all the time 1 2 3 4 5 6 7 never

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SCORING INSTRUCTIONS FOR IPPA

 

You can calculate 3 scores for the IPPA:

Section 1: Life Purpose and Satisfaction (LPS)

Section 2: Self Confidence During Stress (SCDS)

Total: Confidence in Life and Self (CLS)

 

1. For each individual question, the number that you circled is your score.

2. Add your scores for the questions in each section.

3. Add your two section scores to make a total score.

4. Divide each sum by the number of questions in that section (use a calculator):

Life Purpose and Satisfaction: (Sum of scores) ______ 17 = _____.___

 

Self-Confidence During Stress: (Sum of scores) ______  15 = _____.___

 

TOTAL:

Confidence in Life and Self: (Sum of scores) ______ 32 = _____.___

 

Note: Each score should range between 1.00 and 7.00.

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Scores may include decimals (example: 5.15).

 

INTERPRETATION

 

High = 5.51 – 7.00

Medium High = 4.01 – 5.50

Medium Low = 2.50 – 4.00

Low = 1.00 – 2.49

Most adults from test sites in the USA score between 4.03 and 5.87. The average score is 4.95.

 

Your score on each scale reflects how strongly you feel these resilient attitudes. Do these scores make sense to you—as you reflect on your life?

 

Review the individual questions. Each answer shows you particular attitudes and areas of your life where your worldview is—or is not—resilient. Do you notice any patterns?

If there is a large difference between your LPS and SCDS scores, one part of your worldview is more resilient than the other part. This difference identifies the part of your worldview that you most need to strengthen.

If your combined score on both scales is low (or even medium low), don’t hide this fact from yourself or others. Seek support. Talk with a minister, counselor, or friend about how you are feeling about yourself and your life.

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Part II: Building Confidence in Life and Self Through Spirituality

One of the most valuable inner resources that you can develop is your own spirituality. Spirituality is a particularly effective way to build a resilient worldview. Spirituality, of course, is not the only way to develop resilient attitudes. However, for countless generations and in countless cultures, spirituality has been a primary source of resilience for individuals, families, and communities.

The next questionnaire will help you to clarify the degree to which spirituality is a central aspect of your life. If it is not central, this questionnaire may help you to think about spirituality in some new ways—and your results on this questionnaire may surprise you.

The essence of spirituality is not whether—or how often—you attend religious services. Rather, the essence of spirituality is the way that you experience life. Spirituality is the experience of connection to the sacred aspect of life, the spirit of life.

            For some of us, the experience of the spirit of life grows from a sense of connection

            to our own inner, creative core.  

            For some, this experience grows from a sense of connection to other people.

            For some, this experience grows from a sense of connection to nature.

For some, this experience grows from a sense of connection to a power that is greater than our selves: the ground of being, God.

Over time, an exploration of your spirituality can lead you to new experiences in each of these areas. For these experiences share a common thread: recognition of the spiritual core that creates and sustains the fabric of life.

As your sense of connection to the spirit of life grows, you may also find yourself developing important new skills. You may find yourself able to respond to crises and difficulties in a new way: with a sense of empowerment and life purpose. As you develop a sense of connection to the spirit of life, you may discover yourself becoming a more resilient person who can respond to stress with confidence in life and self.

This questionnaire will help you to measure the degree to which you have already begun to develop a sense of connection with the spiritual core of life. It is called the Index of Core Spiritual Experiences (INSPIRIT). If your score is low, this questionnaire may spur you to an exploration of your spirituality—in a way that is meaningful and appropriate for you. If your score is high, this

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questionnaire will confirm your sense of connection to the spirit of life. In each case, you can use the results from this questionnaire to determine how much your spirituality now contributes to a resilient worldview.

 

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INDEX OF CORE SPIRITUAL EXPERIENCES

SELF TEST VERSION

(INSPIRIT-R)

  

The following questions concern your spiritual or religious beliefs and experiences. There are no right or wrong answers. For each question, circle the number of the answer that is most true for you.

 

1. How strongly religious (or spiritually-oriented) do you consider yourself to be?

1. Not at all

2. Not very strong

3. Somewhat strong

4. Strong

2. About how often do you spend time on religious or spiritual practices?

1. Once per year or less

2. Once per month to several times per year

3. Once per week to several times per month

4. Several times per day to several times per week

3. How often have you felt as though you were very close to a powerful spiritual force?

1. Never

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2. Once or twice

3. Several times

4. Often

 

PEOPLE HAVE MANY DIFFERENT IMAGES AND DEFINITIONS OF THE HIGHER POWER THAT WE OFTEN CALL GOD. USE YOUR IMAGE AND YOUR DEFINITION OF GOD WHEN ANSWERING THE FOLLOWING QUESTIONS.

 

4. How close do you feel to God?

1. I don't believe in God

2. Not very close

3. Somewhat close

4. Extremely close

5. Have you ever had an experience that has convinced you that God exists?

1. No

2. I don't know

3. Maybe

4. Yes

 

6. Indicate whether you agree or disagree with this statement: "God dwells within you."

1. Definitely disagree

2. Tend to disagree

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3. Tend to agree

4. Definitely agree

 

 

7. The following list describes spiritual experiences that some people have had. Indicate if you have had any of these experiences and the extent to which each of them has affected your belief in God.

 

NEVER HAD HAD THIS EXPERIENCE

THIS AND IT:

EXPERIENCE

Did not Convinced

strengthen Strengthened          me of

belief  belief  God's

in God in Godexistence

 

SPIRITUAL EXPERIENCES:

 

A. An experience of profound

inner peace 1 2 3 4

 

B. An overwhelming

experience of love 1 2 3 4

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C. A feeling of unity with the

earth and all living beings 1 2 3 4

 

D. An experience of complete

joy and ecstasy 1 2 3 4

 

E. Meeting or listening to a

spiritual teacher or master 1 2 3 4

 

F. An experience of God's

energy or presence 1 2 3 4

 

G. An experience of a great

spiritual figure (e.g. Jesus,

Mary, Elijah, Buddha) 1 2 3 4

 

H. A healing of your body or mind

(or witnessed such a healing) 1 2 3 4

 

I. A miraculous (or not

normally occurring) event 1 2 3 4

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J. An experience of angels or

guiding spirits 1 2 3 4

 

K. An experience of communication

with someone who has died 1 2 3 4

 

L. An experience with near death

or life after death 1 2 3 4

 

M. Other (specify)________________ 2 3 4

 

 

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SCORING INSTRUCTIONS FOR INSPIRIT

 

Questions 1 through 6: The number you checked is your score for that question. Add these scores together. Your sum should range from 6 to 24.

 

Question 7 (items A-M): The highest number you checked for any of these items is your score for this question. Your score for Question 7 should be 1, 2, 3, or 4.

 

Sum of Questions 1-6: ___ + Question 7 (highest item) ___ = INSPIRIT Score ____

 

INTERPRETATION

High = 25 – 28

Medium High = 18 – 24

Medium Low = 11 – 17

Low = 7 – 10

Most adults from test sites in the USA score between 16 and 25. The average score is 20 ½.

 

Does your score make sense to you? If not, this test may measure concepts that have not been central to your spirituality. Review each question—and consider whether the INSPIRIT may be suggesting new areas of experience for you to explore. Some questions focus on experiences that convince you of God’s existence. Others concern the strength of your relationship with the spirit of life—and the degree to which you experience God as the ground of your own being. If your score does make sense to you, consider these interpretive guidelines:

 

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HIGH: You often experience a close and intimate connection with the spirit of life. You know, with deep conviction, that the spirit of life is the core of your being.

 

MEDIUM HIGH: You experience a close and intimate connection with the spirit of life. However, this experience may not take place on a regular basis. If your score is 22–24, you may have begun to realize, with a growing sense of conviction, that the spirit of life is the core of your being. If your score is 18-21, you may be testing this possibility.

 

MEDIUM LOW: You have had some experiences concerning the spirit of life, though they have not convinced you that God exists. If your score is 15-17, these experiences have deepened your awareness of life’s spiritual core. If your score is 11-14, these experiences have had little effect on you.

 

LOW: You have had few experiences concerning the spirit of life. If you believe that the spirit of life is the core of your being, this belief has, most likely, not grown out of your personal experience. NOTE: A low score may also mean that you have not acknowledged spiritual experiences that you have had. Perhaps these experiences seemed insignificant or coincidental. Perhaps it seemed embarrassing, or prideful, to admit having them. Keep in mind that experiences of the sacred are part of a human being’s natural capacities--and a vital way to discover your link with God. Allow yourself to acknowledge moments of spiritual connection as they occur in your daily life.

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Part III:

Does Your Spirituality Contribute to a Resilient Worldview?

 

 

SUMMARY OF SCORES

 

DATE___/___/___ NAME (OPTIONAL)__________________________________

 

RESILIENT WORLDVIEW (IPPA)

 

My TOTAL Confidence in Life and Self (CLS) score is: ________

My Life Purpose and Satisfaction (LPS) score is: ________

My Self-Confidence During Stress (SCDS) score is: ________

 

EXPERIENCES OF THE SPIRITUAL CORE (INSPIRIT):

A SENSE OF CONNECTION WITH THE SPIRIT OF LIFE

 

My INSPIRIT score is: ________

 

LIST YOUR SCORES IN THE APPROPRIATE BOXES:

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  CLS LPS SCDS   INSPIRIT  HIGH

 

Score: 5.51 – 7.00

          HIGH

 

Score: 25 – 28

             MEDIUM HIGH 4.95*

Score: 4.01 – 5.50

        MEDIUM

HIGH 20½ **

 

Score: 18 – 24

             MEDIUM LOW

 

Score: 2.50 – 4.00

          MEDIUM LOW

 

Score: 11 – 17

             LOW

 

Score: 1.00 – 2.49

          LOW

 

 

Score: 7 – 10

* 4.95 = Average adult score on IPPA. Most adults from test sites in the USA score between 4.03 and 5.87.

** 20½ = Average adult score on INSPIRIT. Most adults from test sites in the USA score between 16 and 25.

 

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INTERPRETIVE GUIDE

 

This guide can help you determine whether your spirituality contributes to a resilient worldview. Note: This guide refers to HIGH and LOW scores on the IPPA and INSPIRIT scales. MEDIUM HIGH scores fit into the HIGH interpretation—but less strongly. Similarly, MEDIUM LOW scores fit into the LOW interpretation—but less strongly.

 

IPPA scores are HIGH; INSPIRIT score is HIGH:

You have a resilient worldview with a strong sense of confidence in life and self. It is likely that your connection to the spirit of life is a primary source of your empowering worldview. Reflect on the events that have contributed to your spirituality and resilience. How can you continue to develop these health-promoting aspects of your life?

 

IPPA scores are LOW; INSPIRIT score is HIGH:

While you experience your connection to the spirit of life deeply, these experiences may not be translating into resilient attitudes in your life. This is a common occurrence. Absorbed in their spiritual experiences, people may not realize that these experiences are not contributing to positive changes in daily life. Recognizing this disparity is a useful way to bring your spiritual development back into focus. Examine the positive attitudes that need strengthening in your life. Do your spiritual activities and experiences contribute directly to the strengthening of these attitudes? If not, seek to develop a focus to your spirituality that will help you to develop confidence in life and self more effectively.

 

IPPA scores are HIGH; INSPIRIT score is LOW:

It is likely that spirituality is not the primary source of your resilient attitudes. This is true for many people. It is important to remember that spirituality is not the only source of a resilient worldview. At the same time, a high degree of confidence in life and self often indicates a sense of harmony with the world and a sense of connection with others that are integral parts of a spiritual worldview. Is it possible that you have not acknowledged a spiritual element in your life? If so, examine where this lack of acknowledgment of your own spirituality comes

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from. Such an examination often provides useful insights into the events that have shaped your personal development.

 

IPPA scores are LOW; INSPIRIT score is LOW:

If you are a person whose life experiences and personal relationships have not enabled or taught you to develop confidence in life and self, this may be a moment to recognize that spirituality can be an important source of personal resilience. As you learn to experience the spirit of life as the core of your own being, your self-esteem will begin to rise. Then, you can learn to tap the power and strength of your own inner self. As your inner self grows more empowered, you will become able to discover meaning and purpose in your life that you may not have known how to recognize. As a result, you can develop the courage to act in more confident and creative ways. If your low INSPIRIT score represents a lack of spiritual grounding, seek help from others to develop spirituality into a source of empowerment and resilience.

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Personal Notes: