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[...]countries have experienced severe economic loss, with an average reduction of national GDP of about 3%, with some countries up to 15% (Fernandes, 2020), and increased mental health concerns reported among the public (e.g., 16-28% of screened individuals endorsed depressive and anxiety symptoms; Rajkumar, 2020). [...]the integration of mental health interventions will prove to be a critical factor in the battle against COVID-19. Redemptive purpose involves one's confidence in renewing and replenishing a sense of meaning and purpose for life through the difficulty. [...]SF can be viewed as a personality trait that allows one to transcend adversity by consistently drawing on religious and spiritual resources. Since its introduction to the field,
The COVID-19 pandemic is a global traumatic stressor affecting millions of individuals worldwide. Traumatic events often cause significant resource loss and negatively affect mental health and emotional well-being. In the wake of trauma, many people draw on religious or spiritual faith to cope with adversity and suffering. One construct that has received increased attention within the field of religious/spiritual coping is spiritual fortitude (SF), which is one's ability to consistently draw on spiritual and religious resources to cope with negative emotions in the face of stressors (Van Tongeren et al., 2018). In this paper, we present data from 255 participants who completed measures of resource loss related to the ongoing COVID-19 pandemic, SF, depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms. SF buffered the deleterious relationship between resource loss and mental health symptoms. Specifically, for individuals high in SF, the relationship between resource loss and mental health symptoms was weaker than for individuals low in SF. We conclude by discussing limitations of the current study, areas for future research, and implications for practice.
COVID-19 is one of the most devastating disasters of the 21st century. Natural disasters (e.g., epidemics, hurricanes, landslides, tsunamis, or floods) often harm people's health, the economy, and society (Basu & De, 2003; Boucekkine & Laffargue, 2010; Cherry et al., 2010; Ghodse & Gales, 2006; Jonkman & Vrijling, 2008; Udomratn, 2008). COVID-19 is one of the most devastating tragedies in human history, with more than 28,000,000 cases diagnosed and about 920,000 confirmed deaths around the globe as of September 13, 2020 (John Hopkins University, 2020). In addition to direct consequences to health, it will also have long-standing indirect consequences on public health and mental health. For example, countries have experienced severe economic loss, with an average reduction of national GDP of about 3%, with some countries up to 15% (Fernandes, 2020), and increased mental health concerns reported among the public (e.g., 16-28% of screened individuals endorsed depressive and anxiety symptoms; Rajkumar, 2020).
In the United States alone, there are 6.4 million confirmed cases of COVID-19 and more than 200,000 deaths as of September 23, 2020 (John Hopkins University, 2020). The lingering effects of the pandemic will likely last several years, as evidenced by the multiple forecasts of rising national and global deaths (e.g., Hamzah et al., 2020; Petropoulos & Makridakis, 2020). Furthermore, past epidemicbased research has shown that (a) the number of people whose mental health is negatively impacted tends to exceed the number of people affected by the infection itself (Shigemura et al., 2020) and (b) mental health symptoms can outlast the epidemics themselves (Reardon, 2015). As a result, the integration of mental health interventions will prove to be a critical factor in the battle against COVID-19.
COVID-19, Resource Loss, and Mental Health
Traumatic events such as pandemics can often cause significant resource loss and therefore negatively impact survivors' mental and physical well-being (Van Der Kolk, 1987). COVID-19, for instance, has been associated with the loss of protective factors for mental health for affected individuals (e.g., loved ones, financial resources and daily routines; Gruber et al., 2020). Hobfoll (1989) categorized resource loss into four categories: object (e.g., shelters, clothes, vehicles); condition (e.g., marriage, social status, seniority); personal characteristics (e.g., discipline, competence); and energy (e.g., time, money, knowledge). Loss, or threat of loss, of any of the above resources can render one psychologically and mentally vulnerable and stressed (Hobfoll, 1989). Resource loss has also been associated with serious deleterious emotional and psychological outcomes. For example, in a study where researchers controlled for general anxiety, sense of coherence, and coping style, resource loss was found to be linked with psychological distress (Freedy et al., 1992). In addition, ample research has associated lack of resources (e.g., loss of financial resources, weak social support) to poorer functioning in general (e.g., Holahan et al., 1999; Kaniasty & Norris, 1995).
Further, multiple lines of research have demonstrated the emotionally devastating effects associated with traumatic events such as natural disasters, including the disruption of one's worldview and sense of safety, security, and meaning (Park, 2016; Park et al., 2017). Specifically, COVID-19 has been linked to several adverse psychological outcomes, including role confusion, family conflict, and parental burnout (Gruder et al., 2020; Manjoo, 2020), general distress (Lai et al., 2020), and an increase in relapses of substance abuse in certain individuals (Volkow, 2020).
Multiple lines of research have also linked exposure to COVID-19 to increased anxiety (e.g., Nemati et al., 2020; Huang et al., 2020; Shanafelt et al., 2020). For example, Cao et al. (2020) found that exposure to COVID-19 was associated with mild to severe anxiety among medical college students. Utilizing the Generalized Anxiety Disorder Scale (GAD-7), researchers discovered .9% of participants reported severe anxiety and 24% reported mild to moderate anxiety. They also found a positive relationship between specific aspects of COVID-19 (e.g., financial hit, delays in academic activities, having family members infected with COVID-19) and anxiety development. Additionally, research has demonstrated that living through COVID-19 has been linked to an increase in anxiety among health care professionals. For example, through a systematic review and meta-analysis, Pappa et al. (2020) discovered that about 20% of healthcare professions reported symptoms of anxiety related to COVID-19. Hacimusalar et al. (2020) also found that state anxiety levels of healthcare professionals were higher compared to non-healthcare workers. More specifically, they identified increased working hours as an important factor affecting anxiety, especially among nurses.
COVID-19 has also been linked to the development of depressive symptoms (e.g., Huang & Zhao, 2020; Mazza et al., 2020; Majumdar et al., 2020; Shechter et al., 2020). In one study involving COVID-19 survivors, Mazza et al. (2020) found that 31% of participants reported clinical depression. They also discovered that female COVID-19 survivors reported higher levels of depression compared to their male counterparts. In addition, participants who endorsed a previous psychiatric diagnosis of depression showed increased scores, indicating the distinct role of COVID-19 experience in depressive symptom development (Mazza et al., 2020). In a metaanalysis and systemic review, Salari et al. (2020) also found a high prevalence of depression in the general population during the current pandemic. Specifically, among the 14 studies included in the meta-analysis with a collective sample size of 44,531 people, 33.7% of participants reported symptoms of depression. In another study, 770 COVID-19 patients across five hospitals in Hubei province, China were surveyed and the prevalence rate of depression among these individuals was 43.1% (Ma et al., 2020). Further, Ma et al. (2020) found the following three factors were independently associated with depressive symptoms: (1) having a family member infected with COVID-19, (2) personally going through severe COVID-19 symptoms, and (3) frequent use of media to gain information about COVID-19.
Experiences related to COVID-19 have also been associated with diagnosis of posttraumatic stress disorder (PTSD; e.g., Boyraz & Legros, 2020; Tang et al., 2020). For example, Carmassi et al. (2020) examined PTSD symptoms in healthcare workers facing the COVID-19 outbreak. They concluded that a high percentage of healthcare workers were indeed at significant higher risk for developing PTSD and Posttraumatic Stress Symptoms (PTSS). They also highlighted that certain risk factors (e.g., high exposure level, coping styles) could interfere with healthcare workers' adaption during the COVID-19 pandemic (Carmassi et al., 2020). In an attempt to investigate the differential diagnostic considerations for PTSD among COVID19 survivors, Kaseda and Levine (2020) found that PTSD accounted for some of the survivors' subjective cognitive complaints over and above neuropathology related deficits. Furthermore, PTSD symptoms due to COVID-19 are certainly not exclusive to adults. In a study exploring the effect of COVID-19 on the mental health of youth individuals aged 14-35, Liang et al. (2020) found that 14.4% of surveyed individuals demonstrated PTSD symptoms, as measured by the PTSD Checklist (pCL), suggesting that COVID-19 can have a significant impact on individuals from a wide range of ages.
The Protective Role of Spiritual Fortitude
When coping with traumatic events such as natural disasters, survivors often resort to religious and spiritual resources to develop a better understanding of and cope with their trauma (Feder et al., 2013; Park, 2016). Religious/spiritual resources (e.g., prayer, study of religious literature) allow individuals to make sense of their traumatic experiences (Magezi & Manda, 2016). One spiritual resource that has demonstrated beneficial effects in effective coping in adversarial contexts is spiritual fortitude (SF). SF refers to the concept that one has sufficient spiritual resources to transcend difficult situations (Van Tongeren et al., 2018). SF is comprised of three components: spiritual endurance, spiritual enterprise, and redemptive purpose. Spiritual endurance is one's capacity to utilize religious or spiritual resources to tolerate suffering for a sustained period. Spiritual enterprise involves one's capacity to live according to integrity and high moral standards in the face of the adversity. Redemptive purpose involves one's confidence in renewing and replenishing a sense of meaning and purpose for life through the difficulty. Therefore, SF can be viewed as a personality trait that allows one to transcend adversity by consistently drawing on religious and spiritual resources.
Since its introduction to the field, SF has been studied in various contexts, including natural disasters. For instance, Van Tongeren et al. (2018) investigated the distinctive characteristic of SF in comparison to two related variables: resilience and grit. Although positive associations were discovered between SF and grit and resilience, the researchers also confirmed the distinct nature of SF in relation to grit and resilience, which demonstrated the convergent and incremental validity of SF. That is, SF was associated with protective factors such as higher meaning in life, increased spiritual well-being, and positive religious coping above and beyond grit and resilience (i.e., incremental validity).
Exploring SF in the context of natural disasters, McElroy-Heltzel et al. (2018) examined the role of SF in meaning making and spiritual well-being among victims of Hurricane Matthew. Specifically, to examine the role of SF in facilitating coping using religious/spiritual (R/s) resources in adversity, the researchers recruited 227 undergraduate students from a local university in the affected region and found SF to be associated with meaning in life, positive religious coping, and spiritual wellbeing following the hurricane. In another study, Zhang et al. (2020) examined the role of SF in disaster coping among 274 victims of the 2016 Louisiana flood disaster. Participants completed measures of resource loss, SF, search for meaning, depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms nine and eighteen months after the flooding. SF buffered the deleterious relationship between resource loss and future search for meaning. Given that search for meaning was related to higher levels of mental health symptoms, there are implications for the role of SF in protecting against the development of mental health symptoms following disaster.
Overview and Hypotheses
Although a line of initial research has provided supporting evidence that SF is a character strength that facilitates positive coping amid disaster contexts, there has been a dearth of research on this topic. Moreover, COVID-19 has only captured the attention of the public in recent months. With its dangerous and widespread contagion potential and severe mental health implications, more research is needed that explores effective coping strategies to maintain the emotional well-being of the public in the face of COVID-19. Because SF has displayed some beneficial effects in coping with natural disasters, it may also help in navigating the stress caused by COVID-19. Thus, the current study aimed to investigate the role of SF in ameliorating the negative impact of COVID-19 on mental health symptoms. Specifically, we focused on depression, anxiety, and PTSD symptoms. We hypothesized that (1) pandemic-related resource loss would be positively associated with depression, anxiety, and PTSD symptoms, and (2) SF would moderate the relationships between resource loss and mental health symptoms. Specifically, we expected that the deleterious relationship between resource loss and mental health symptoms would be buffered (i.e., would be attenuated) for participants with high levels of SF.
Method
Participations
Participants were 255 adults (133 Male, 122 Female) recruited from Amazon Mechanical Turk in June 2020 during the COVID-19 pandemic. Participants ranged in age from 23 to 60 years (M = 35.40, SD = 11.44). Participants were primarily White (80%, 7.8% Black, 5.1% Hispanic, 1.6% Asian, 2.4% Native American, 3.1% unidentified) and Christian (89.9%, Muslim 2.7%, Buddhist .4%, Hindu 2.4%, Jewish 2.0%, Atheist 1.6%, Agnostic .4%, None/Other .4%).
Measures
Spiritual Fortitude
We measured SF with the 9-item Spiritual Fortitude Scale (SFS; Van Tongeren et al., 2018). This scale has 3 subscales: Spiritual Endurance (e.g., "My faith helps push me to overcome difficult tasks in life"), Spiritual Enterprise (e.g., "I continue to do the right thing despite facing hardships"), and Redemptive Purpose (e.g., "My sense of purpose is strengthened through adversity"). Participants provided ratings on a 7-point Likert scale ranging from 1 (completely untrue of me) to 7 (completely true of me). The summed total score was created to reflect their responses, with higher scores indicating higher SF. Prior research has shown evidence of internal consistency (Cronbach's alphas ranging from .84 to .86), discriminant validity (e.g., although there was correlation with grit and resilience, the correlation was minimal, suggesting the distinct mechanism of SF; Van Tongeren et al., 2018), and convergent validity (e.g., positive associations with similar constructs including grit and resilience; Van Tongeren et al., 2018). For the present study, the Cronbach's alpha was .80.
Resource Loss
We measured resource loss associated with the COVID-19 pandemic with an 11-item Resource Loss Scale, which was adapted from the 24-item Resource Loss Scale (RLS; Sattler et al., 2006) and assesses participants' degree of loss of condition resources (e.g., family stability, stable employment) and personal characteristic resources (e.g., sense of optimism, feeling one's life has purpose). Participants rated items on a 4-point scale ranging from 1 (no loss) to 4 (extensive loss). The RLS scale has demonstrated good internal reliability in past research (Sattler et al., 2006). There is also evidence for convergent validity for the scale (e.g., resource loss was associated with psychological distress; Freedy et al., 1993). For the current sample, the Cronbach's alpha was .90.
Anxiety
Anxiety was measured with the Generalized Anxiety Disorder 7-item Scale (GAD-7; Spitzer et al., 2006), which assesses the most prominent diagnostic features of GAD, including nervousness, inability to stop worrying, excessive worry, restlessness, difficulty in relaxing, irritability, and fear of something awful happening. Participants rate each item on a 4point Likert scale ranging from 0 (not at all) to 3 (nearly every day), indicating the frequency in which symptoms of anxiety were experienced in the past two weeks. The total score ranges from 0 - 21, with higher scores indicating higher levels of anxiety. In the general population, the GAD-7 has demonstrated high internal consistency (e.g., a = .91), test-retest reliability (e.g., intraclass correlation = .83), convergent validity (e.g., high scores on the GAD-7 were strongly related with multiple domains of functional impairments), and criterion validity (Spitzer et al., 2006). For the present sample, the Cronbach's alpha was .86.
Depression
Depression was measured with the Center for Epidemiological Studies-Depression Scale (CES-D; Radloff, 1977). CES-D is composed of 20-items that assess the frequency of major symptoms of depression. participants rated each item on a 4-point Likert scale ranging from 0 (rarely or none of the time) to 3 (most or all of the time). CES-D total scores range from 0 to 60, with higher scores indicating more urgent need for clinical evaluation and intervention for major depression. A threshold score of 16 is a marker of the need for clinical evaluation. The CES-D contains four subscales: positive affect (e.g., "I enjoyed life), negative affect (e.g., "I felt lonely"), somatic symptoms and retarded activity (e.g., "I had trouble keeping my mind on what i was doing"), and interpersonal difficulties (e.g., "I felt like people disliked me"). The CES-D has demonstrated high concurrent and construct validity as well as high reliability across various populations (Devins et al., 1988). For example, across multiple studies, Cronbach's alphas ranged from .85 to .90 (Radloff, 1977; Hunter et al., 2003). Also, 3-week test-retest reliability was .78 (Fichtel & Larsson, 2002). The CES-D also displayed convergent validity and was positively associated with the Hamilton Clinician's Rating scale and the Raskin Rating scale, with moderate associations ranging from .69 to .75 (Radloff, 1977). Also, the CESD D demonstrated predictive validity in identifying depressive symptoms in with hepatitis C (Clark et al., 2002). For the present sample, the Cronbach's alpha was .88.
Posttraumatic Stress Disorder (PTSD)
We measured PTSD symptoms with the PTSD Checklist for DSM-5 (PCL-5; Weathers et al., 2013), which is a 20-item self-report measure to assess the severity of PTSD symptoms in accordance with the diagnostic criteria established by the DSM-5 (American Psychiatric Association, 2013). The updated version of the PCL-5 thus contains a factor structure that reflects the new DSM-5 criteria but should provide the same utility as the PCL-IV (Weathers et al., 2014). Participants rate items on a 5-point Likert scale for the severity of their PTSD symptoms in the past 30 days ranging from 0 (not at all) to 4 (extremely). The original version of PCL demonstrated good reliability as evidenced by test-retest reliability (e.g., .96 over 2-3 days) and internal consistency (e.g., a =.97; Wilson & Keane, 2004). The PCL-5 has also demonstrated strong convergent and discriminant validity (e.g., strong positive correlation of .85 with the Detailed Assessment of Posttraumatic Stress [DAPS], moderate positive correlation of .39 with Antisocial Personality Feature; Blevins, 2015). For the current sample, the Cronbach's alpha was .96.
Procedure
Participants were recruited from Amazon Mechanical-Turk during the COVID-19 pandemic. Participants first read a consent form and indicated consent to participate. Then, participants completed a set of questionnaires online. After completing the questionnaires, participants were debriefed and given the contact information of the investigator should they have questions. Upon finishing the survey, participants received a small monetary compensation of $1.75.
Results
Data Cleaning and Descriptive Statistics
Before conducting the primary analyses, we screened the data using the following criteria: (1) missing data, (2) validity check questions, (3) completion time, (4) qualitative responses, and (5) response consistency. Participants who failed any of the above screening criteria were deleted from the dataset, leaving 255 participants for the main analyses. Next, we checked the data for outliers and normality. There were a small number of outliers (less than 3% per variable), which we recoded to three standard deviations above or below the mean. Last, we checked normality of the data by investigating skewness, kurtosis, and range for each outcome variable. The data did not display evidence of non-normality, so no data transformations were required. Means, standard deviations, and intercorrelations among study variables are presented in Table 1.
Resource Loss and Mental Distress
The first research question explored the relationships between resource loss and mental health symptoms. We hypothesized that resource loss would be positively associated with depression, anxiety, and PTSD. To test this hypothesis, we examined the correlations between resource loss and depression, anxiety, and PTSD. This hypothesis was supported. Resource loss was positively associated with depression (r = .38, p < .001), anxiety (r = .23, p < .001), and PTSD (r = .37, p < .001).
The Moderating Role of Spiritual Fortitude on Resource Loss and Mental Distress
Our second main hypothesis was that SF would moderate the relationship between resource loss and mental health symptoms (i.e., anxiety, depression, and PTSD). We expected that the relationship between resource loss and mental health symptoms would be weaker for participants with high levels of spiritual fortitude compared to participants with low levels of spiritual fortitude. We tested this hypothesis using a hierarchical regression analysis as outlined by Aiken and West (1991). The predictor and moderator variables were standardized to reduce multicollinearity and to aid interpretation.
First, we examined depression. In Step 1, resource loss and SF predicted about 8% of the variance in depression (R2 = .08, F(2, 252) = 11.38, p < .001). In Step 2, the addition of the interaction term predicted an additional 3% of variance in depression (AR2 = .03, ДД, 251) = 8.38, p = .004). In the final model, resource loss was a significant positive predictor of depression (ß = .40, p < .001), and SF was a significant negative predictor (ß = -.25, p = .001). These main effects were qualified by a significant interaction between resource loss and SF (ß = -.18, p = .004). interpret the interaction, we graphed the interaction and conducted a simple slopes analysis (see Figure 1). At low levels of SF, resource loss was a significant positive predictor of depression (ß = .55, p < .001). At high levels of SF, resource loss was still a significant positive predictor of depression (ß = .24, p = .002), but the effect was attenuated.
Second, we examined anxiety. In Step 1, resource loss and SF predicted about 12% of the variance in anxiety (R2 = .12, F(2, 252) = 17.66, p < .001). In Step 2, the addition of the interaction term predicted an additional 2% of variance in anxiety (AR2 = .02, F(1, 251) = 6.98, p = .009). In the final model, resource loss was a significant positive predictor of anxiety (ß = .43, p < .001), but the main effect of SF was not significant (ß = -.10, p = .145). The interaction between resource loss and SF was significant (ß = -.16, p = .009). interpret the interaction, we graphed the interaction and conducted a simple slopes analysis (see Figure 2). At low levels of SF, resource loss was a significant positive predictor of anxiety (ß = .57, p < .001). At high levels of SF, resource loss was still a significant positive predictor of anxiety (ß = .29, p < .001), but the effect was attenuated.
Third, we examined PTSD symptoms. In Step 1, resource loss and SF predicted about 15% of the variance in PTSD symptoms (R2 = .15, Д2, 252) = 22.67, p < .001). In Step 2, the addition of the interaction term predicted an additional 3% of variance in PTSD symptoms (AR2 = .03, F1, 251) = 10.24, p = .002). In the final model, resource loss was a significant positive predictor of PTSD symptoms (ß = .51, p < .001), and SF was a significant negative predictor (ß = -.19, p = .007). These main effects were qualified by a significant interaction between resource loss and SF (ß = -.19, p = .002). interpret the interaction, we graphed the interaction and conducted a simple slopes analysis (see Figure 3). At low levels of SF, resource loss was a significant positive predictor of PTSD symptoms (ß = .67, p < .001). At high levels of SF, resource loss was still a significant positive predictor of PTSD symptoms (ß = .34, p < .001), but the effect was attenuated.
Discussion
The current COVID-19 pandemic is a significant stressor, eliciting physical risks, financial distress, physical and social isolation, uncertainty, and disruptions of daily routines, all of which are taking a toll on affected individuals and adversely impacting the public mental health (Gruber et al., 2020). In recent years, SF has been reported to be a protective personal characteristic associated with improved mental health and well-being (e.g., meaning in life, spiritual well-being, positive religious coping; ameliorated impact of resource loss on mental health symptoms; McElroy-Heltzel et al., 2018; Van Tongeren et al., 2018; Zhang, et al., 2020). The present study answers a timely call of public mental health by examining SF in the context of the ongoing global pandemic. We adopted the construct of SF for the current study because it addressed an urgent need in assisting people in coping more effectively against the difficulties associated with a prolonged public health crisis (i.e., the resource loss following the COVID-19 pandemic). Specifically, we examined the role of SF in buffering the adverse effects of resource loss on individuals' psychological distress (i.e., anxiety, depression, and PTSD).
Our hypothesis that resource loss would be related to negative mental health symptoms was supported, as higher levels of resource loss were related to symptoms of anxiety, depression, and PTSD. These findings correspond with Hobfoll's (1989) theory on resource loss in that experiences related to resource loss often cause psychological distress. The results were also consistent with past findings indicating that resource loss played a significant role in one's emotional struggles (Freedy et al., 1992) and that individuals struggling with resource loss tended to demonstrate worse functioning in general compared to their counterparts with enough resources (Holahan et al., 1999).
Our hypothesis that SF would buffer the deleterious relationship between resource loss and mental health symptoms was also supported. Specifically, SF was a significant moderator of the relationship between resource loss and depression, anxiety, and PTSD symptoms among the individuals affected by the COVID19 pandemic. This finding that SF buffered against mental distress supports the idea that SF may be an important aspect of coping with adversity for religious and spiritual individuals, because individuals high in SF may possess the needed spiritual resources to face, and grow in, difficult times (Van Tongeren et al., 2018). Given that mental distress including depression usually involves a sense of meaninglessness and lack of purpose (American Psychiatric Association, 2013), the redemptive purpose aspect of SF (i.e., confidence that one is able to renew the sense of meaning and purpose for life; Van Tongeren et al., 2018) may provide some instilment of hope in disaster survivors. This finding was also consistent with the demonstrated positive effects of SF in increasing meaning in life (McElroy-Heltzel et al., 2018) and spiritual well-being (Van Tongeren et al., 2018).
Limitations and Suggestions for Future Research
The findings of the present study should be interpreted in light of its limitations. First, the current study recruited participants through Amazon Mechanical Turk, an online survey platform. Therefore, there was no control over the setting in which participants finished the survey, which could impact participants' ability to focus and maintain their attention over time (e.g., a loud and interruptive home environment due to all family members locked down at home). Also, although the current sample included individuals of various genders, racial/ethnic groups, and religions, the participants were mostly White (80.0%), and Christian (89.9%). Future studies could consider exploring these variables in more diverse racial and religious groups.
Second, the current study utilized a crosssectional, correlational design. Thus, causal conclusions should not be made. Although our theoretical model described variables such as resource loss predicting mental health outcomes, and the data was consistent with our hypotheses, other theoretical models could also fit with the data. For example, depression could cause individuals to experience certain types of resource loss (e.g., loss of energy). Or, there may be a third variable that could impact both resource loss and mental health symptoms. Longitudinal (i.e., pre- and postdisaster data) or experimental research could further explain the underlying mechanisms of these relationships.
Third, the current study used self-reported ratings. John and Robins (1993) argued that self-report measures are susceptible to socially desirable responding. To avoid this concern in future studies, alternative measures such as behavioral measures (Dorn et al., 2014) or implicit measures (Rowatt et al., 2006) could be utilized.
Fourth, although the current study examined the relationship between SF and mental health, only three mental health symptoms were explored (i.e., depression, anxiety, and PTSD). Future studies could expand the range of mental health symptoms to gain a more comprehensive understanding of the psychological health of individuals during a pandemic.
Finally, the order of questionnaires presented in the survey could have influenced the participants' result. Since all participants completed the questionnaires in the same order, it is possible that completing an earlier questionnaire could have an impact on their later performance. Future studies may counterbalance the order the measures presented to participants.
Practical Application
our findings shed light on how individuals who are dealing with natural disasters, such as pandemics, might work to cope with their struggles and guard against negative mental health symptoms in the face of traumatic events. Specifically, R/S people low in SF may be more prone to depression, anxiety, and PTSD during these difficult conditions due to the absence of the protective role SF may have against high resource loss. This suggests that external supports (e.g., family support, government assistance) may be more necessary and helpful to individuals low in SF. On the other hand, people high in SF may find it easier to cope with resource loss and develop less anxiety, depression, and PTSD. SF may also help support personnel (e.g., healthcare workers, frontline counselors) who may be disproportionally impacted during a public health crisis such as COVID-19.
our findings also bear important implications for mental health professionals and R/S leaders and individuals who regularly interact with R/S individuals or are exposed to a prolonged adversity or traumatic event, like the COVID-19 pandemic. For instance, mental health professionals (e.g., counselors, psychologists) could design a training program that could enhance individuals' understanding of SF (e.g., psychoeducation of benefits of SF) and one's efficacy of practicing and utilizing SF (e.g., experiential exercises that renew one's sense of meaning that in turn enhance one's redemptive purpose). R/S leaders or individuals, on the other hand, could remind themselves or their peers of the protective role of SF when they find themselves amidst prolonged adversarial situations so that they could more efficiently draw on their spiritual resources to withstand suffering, fortify their character strength of integrity, and derive deeper meaning and purpose of life.
Conclusion
COVID-19 not only carries a physical health threat to the public, but has been associated with negative outcomes of mental health (e.g., Huang et al., 2020; Majumdar et al., 2020; Mazza et al., 2020; Nemati et al., 2020; Shanafelt et al., 2020). current study demonstrated the beneficial role of SF in buffering against the negative impact of COVID-19 on mental health. Given the positive effects of SF in recent research, we encourage researchers to further explore the role of SF in other public health crises, as well as in various contexts of adversity (e.g., financial crisis due to market crash, adaptation difficulty for college students). In a world ridden by natural and human-made disasters, SF may prove to be a consistent and valuable coping resource in midst of adversity and suffering.
Author note
Correspondence concerning this article should be addressed to Hansong Zhang, Department of Psychology, University of North Texas, 1155 Union Circle #311280 Denton, TX 76203. Email: [email protected]
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