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Cited by 50Religion, Spirituality, and PsychologyChild Welfare and AdoptionResilience and Mental Health

The relationship between spirituality and resilience and well-being: a study of 529 care leavers from 11 nations.

Open access
Howard, Amanda Hiles, Roberts, Megan, Mitchell, Tony, Wilke, Nicole Gilbertson·2023·Adversity and Resilience Science
DOI 10.1007/s42844-023-00088-yPMC PMC9918825
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Abstract

Research has found that individuals who were separated from parental care and experienced alternative care settings during childhood are more likely to have poor outcomes as adults. This highlights the importance of understanding factors that are related to resilience and well-being for care leavers. A growing body of research has supported the importance of spirituality in our understanding of resilience and well-being. However, little work to date has examined the relationship of spirituality to outcomes in care leavers. The current study investigated the relationships between spirituality, resilience, well-being, and health in a sample of 529 care leavers from 11 nations. It also examined how different themes of spirituality were related to specific outcome variables. Data revealed that spirituality was significantly associated with higher life satisfaction, better mental and physical health, and more resilience even when accounting for current age, gender, age at separation, Human Development Index scores, and childhood adversity. Furthermore, findings indicate that different themes of spirituality are related to specific outcome variables, even when accounting for demographic information. Findings indicate that spirituality may play an important role in resilience and well-being for care leavers. Implications and limitations are discussed.

AI snapshot

Written from the paper’s full text.

TL;DR

In a cross-sectional survey of 529 care leavers from 11 nations, spontaneous references to spirituality were associated with higher life satisfaction, better mental and physical health, and greater resilience, even after accounting for age, gender, age at separation, HDI, and childhood adversity. Specific spirituality themes related to different outcomes, but causality cannot be inferred.

Key findings

  • Participants who made two or more spirituality references reported significantly higher life satisfaction (M = 22.55, SD = 6.83) than those with no references (M = 19.57, SD = 7.14) or one reference (M = 19.14, SD = 6.75); they also reported better physical health (M = 52.08, SD = 7.26 vs. no references M = 49.10, SD = 8.85) and more resilience (M = 3.46, SD = 0.83 vs. no references M = 3.11, SD = 0.77).
  • For mental health, participants with one reference (M = 46.81, SD = 8.54) or two or more references (M = 46.51, SD = 8.24) reported better mental health than those with no references (M = 43.77, SD = 9.14).
  • Significant interactions between ACE category and spirituality reference category were found for life satisfaction, physical health, and resilience; among care leavers with four or more ACEs, those making two or more spirituality references reported higher life satisfaction (M = 22.54, SD = 6.62) than those making no references (M = 17.60, SD = 7.05) or one reference (M = 18.69, SD = 6.75).
  • Among the 205 participants who made spirituality references, regression models showed relationship to God was associated with life satisfaction (Beta = 0.193), mental health (Beta = 0.202), and resilience (Beta = 0.295); spiritual teachings/teachers with life satisfaction (Beta = 0.178) and resilience (Beta = 0.171); spiritual community support with physical health (Beta = 0.224) and resilience (Beta = 0.170); spiritual identity development with physical health (Beta = 0.160); and higher purpose with resilience (Beta = 0.193). Total number of spirituality references was not associated with any outcome in these regressions.

Methods

  • Cross-sectional, retrospective online survey of 529 care leavers from 11 nations who reported separation from biological parents during childhood for at least 6 months and placement in residential (78.8%) or foster care (35.3%); 14.2% reported both placement types. Participants were 53.9% male, aged 18–89 (M = 27.90, SD = 10.51), with age at separation 0–17 (M = 6.46, SD = 4.44).
  • Spirituality was assessed through spontaneous references in 15 open-ended survey questions, not direct spirituality measures; 494 spirituality-related references were identified, and participants were grouped as none (n = 324), one (n = 92), or two or more (n = 113). Six themes emerged: relationship to God, spiritual community support, higher purpose, identity development, spirituality-based teachings and teachers, and spirituality-based servanthood.
  • Outcomes were life satisfaction (Satisfaction with Life Scale, alpha = 0.805), resilience (Brief Resilience Scale, alpha = 0.717), and physical/mental health (SF-12; physical alpha = 0.841, mental alpha = 0.821); ACEs were measured with a 10-item questionnaire (alpha = 0.725). Analyses included correlations, MANCOVAs controlling for current age, age at separation, and HDI, and multiple regressions among those who made spirituality references.

Limitations

  • The paper states the original survey was not intended to examine spirituality and analyses relied on spontaneous references; it also defined spirituality, religiosity, and faith as a singular construct, and recommends future studies use psychometrically valid measures and differentiate the concepts.
  • The paper states the cross-sectional, retrospective design prevents causal inference; convenience and chain referral sampling, a one-time online survey, and translation into only a few languages limit generalizability. Participants needed internet access and literacy, likely biasing the sample toward urban, educated, higher-SES care leavers with potentially more positive outcomes; recruitment through an alliance for faith-based organizations may also overrepresent those engaged in spirituality/faith.
  • Evident from the text: negative spirituality references were excluded from analysis (0.35% of references), and the spirituality-theme regressions included only the 205 participants who made at least one spirituality reference.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1007/s42844-023-00088-y

Cites

62 of 62 references verified0 citation errors · 0 not checkable

Statistics

15 tests recomputed · 1 with the reported and recomputed p on opposite sides of .05

Claims the paper makes

0 of 42 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Among care leavers who reported four or more ACEs, those who made two or more spirituality references reported significantly higher life satisfaction than those who made no spirituality references or one spirituality reference.

    “Specifically, care leavers who had four or more ACEs and made two or more spirituality references (M = 22.54; SD = 6.62) reported significantly higher life satisfaction than those who made no spirituality references (M = 17.60; SD = 7.05) or one spirituality reference (M = 18.69; SD = 6.75).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Spontaneous references to spirituality made in open-ended survey responses are a valid indicator of participants' spirituality.
  • Findingown data

    Among care leavers who reported less than four ACEs, those who made one spirituality reference reported significantly lower resilience than those who made no references or two or more references.

    “Individuals who reported less than four ACEs and made one spirituality reference (M = 2.76; SD = 0.89) reported significantly lower resilience than those who made no references (M = 3.34; SD = 0.60) or two or more references (M = 3.53; SD = 0.77).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Spontaneous references to spirituality made in open-ended survey responses are a valid indicator of participants' spirituality.
  • Findingown data

    For life satisfaction, data did not reveal significant differences for spirituality references other than relationship to God and spiritual teachings/teachers.

    “Data did not reveal significant differences for those who made other types of spirituality references.”
    Quote in the paperNot a substantial claim
  • Findingown data

    In the life satisfaction model, ACEs were negatively related to life satisfaction (Beta=-0.192, p<0.01).

    “ACEs (Beta = − 0.192, p < 0.01)”
    Quote in the paperNot a substantial claim
  • Findingown data

    Care leavers with two or more spirituality references reported significantly better physical health than those who made no spirituality references or one spirituality reference.

    “In terms of physical health, results indicated that care leavers with two or more spirituality references (M = 52.08; SD = 7.26) reported significantly better physical health than those who made no spirituality references (M = 49.10; SD = 8.85) or one spirituality reference (M = 49.67; SD = 9.06).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Spontaneous references to spirituality made in open-ended survey responses are a valid indicator of participants' spirituality.
  • The quote only partly states this claim. 3
  • May combine two claims. 28
  • Classified as probably not a substantial claim. 21

  • The quote only partly states this claim.

    Findingown data

    For mental health, data did not reveal significant differences for spirituality references other than relationship to God.

    “Data did not reveal significant differences for those who made other types of spirituality references.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In MANCOVA, the number of spirituality references was significantly related to life satisfaction, mental health, physical health, and resilience.

    “Data revealed that the number of spirituality references was significantly related to satisfaction with life, F (1, 529) = 6.14, p < 0.01, ŋ2 = 0.023; mental health, F (1, 529) = 4.12, p < 0.01, ŋ2 = 0.016; physical health, F (1, 529) = 3.01, p < 0.01, ŋ2 = 0.011; and resilience, F (1, 529) = 9.14, p < 0.01, ŋ2 = 0.034.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Spontaneous references to spirituality made in open-ended survey responses are a valid indicator of participants' spirituality.

  • May combine two claims.

    Findingown data

    ACE categories were significantly related to life satisfaction, mental health, and physical health, but not resilience.

    “Data revealed that ACE categories were significantly related to satisfaction with life, F (1, 529) = 12.97, p < 0.01, ŋ2 = 0.024; mental health, F (1, 529) = 11.74, p < 0.01, ŋ2 = 0.022; and physical health, F (1, 529) = 4.08, p < 0.01, ŋ2 = 0.008.”
    • Also stated in: § Relationship Between DVs, Spirituality References, and ACEs · plain
      “Resilience was not significant for the ACE categories.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    HDI of nation of residence during childhood was significantly related to life satisfaction; care leavers who resided in nations with higher HDIs during childhood had more satisfaction with life.

    “Findings indicated that life satisfaction differed by HDI of nation of residence during childhood, F (1, 529) = 23.98, p < 0.01, ŋ2 = 0.044. Care leavers who resided in nations with higher HDIs during childhood had more satisfaction with life.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The interaction between spirituality reference categories and ACE categories was significantly related to life satisfaction, physical health, and resilience, but not mental health.

    “Data revealed that the interaction was significantly related to satisfaction with life, F (1, 529) = 10.27, p < 0.01, ŋ2 = 0.038; physical health, F (1, 529) = 8.02, p < 0.01, ŋ2 = 0.030; and resilience, F (1, 529) = 8.62, p < 0.01, ŋ2 = 0.032.”
    • Also stated in: § Relationship Between DVs, Spirituality References, and ACEs · plain
      “Mental health was not significant for the interaction of spirituality references categories and ACE categories.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Spontaneous references to spirituality made in open-ended survey responses are a valid indicator of participants' spirituality.

  • May combine two claims.

    Findingown data

    A substantial number of participants made one (17.4%) or more (21.4%) spontaneous spirituality references.

    “However, a substantial number of participants made one (17.4%) or more (21.4%).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Spontaneous references to spirituality made in open-ended survey responses are a valid indicator of participants' spirituality.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Participants reported residing in 11 nations during childhood.

    “Participants reported residing in 11 nations during childhood (i.e., the nation in which they were separated from their biological parents).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The total number of spirituality references was significantly positively correlated with life satisfaction, mental health, physical health, and resilience.

    “Furthermore, the total number of spirituality references was significantly positively correlated with life satisfaction, mental health, physical health, and resilience.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Spontaneous references to spirituality made in open-ended survey responses are a valid indicator of participants' spirituality.

  • May combine two claims.

    Findingown data

    The total number of ACEs was significantly negatively correlated with life satisfaction, mental health, physical health, and resilience.

    “The total number of ACEs was significantly negatively correlated with life satisfaction, mental health, physical health, and resilience.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Adults with care experience with four or more ACEs reported significantly lower life satisfaction and poorer mental and physical health than those with fewer than four ACEs.

    “Data revealed that adults with care experience with four or more ACEs reported significantly lower life satisfaction (4 + M = 18.70; SD = 7.14; > 4 M = 22.73; SD = 6.29) and poorer mental (4 + M = 43.45; SD = 9.14; > 4 M = 47.48; SD = 7.98) and physical health (4 + M = 48.50; SD = 9.00; > 4 M = 52.25; SD = 7.38).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The multiple linear regression model for physical health with predictors current age, age at separation, gender, total ACEs, HDI of nation of residence during childhood, and type of spirituality references was significant (F(7,205)=2.81, p<0.001) and explained 15.0% of the variance.

    “The multiple linear regression model for physical health with the predictors of current age, age at separation, gender, total ACEs, HDI of nation of residence during childhood, and type of spirituality references was significant, F (7, 205) = 2.81, p < 0.001, and explained 15.0% of the variance (R2 = 0.150).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The multiple linear regression model predicting mental health from current age, age at separation, gender, total ACEs, HDI of nation of residence during childhood, and type of spirituality references was significant (F(7,205)=2.96, p<0.001) and explained 15.6% of the variance.

    “The multiple linear regression model predicting mental health from current age, age at separation, gender, total ACEs, HDI of nation of residence during childhood, and type of spirituality references was significant, F (7, 205) = 2.96, p < 0.001, and explained 15.6% of the variance (R2 = 0.156).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The multiple linear regression model for life satisfaction with predictors current age, age at separation, gender, total ACEs, HDI of nation of residence during childhood, and spirituality themes was significant (F(7,205)=5.05, p<0.001) and explained 24.0% of the variance.

    “The multiple linear regression model for life satisfaction with the predictors of current age, age at separation, gender, total ACEs, HDI of nation of residence during childhood, and spirituality themes was significant, F (7, 205) = 5.05, p < 0.001, and explained 24.0% of the variance (R2 = 0.240).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based). The quote only partly states this claim.

    Findingown data

    For physical health, data did not reveal significant differences for spirituality references other than spiritual community support and spiritual identity development.

    “Data did not reveal significant differences for those who made other types of spirituality references.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    For resilience, data did not reveal significant differences for spirituality references other than relationship to God, spiritual community support, higher purpose, and spiritual teachings/teachers.

    “Data did not reveal significant differences for those who made other types of spirituality references.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The multiple linear regression model predicting resilience from current age, age at separation, gender, total ACEs, HDI of nation of residence during childhood, and type of spirituality references was significant (F(7,205)=2.55, p<0.01) and explained 13.7% of the variance.

    “The multiple linear regression model predicting resilience from current age, age at separation, gender, total ACEs, HDI of nation of residence during childhood, and type of spirituality references was significant, F (7, 205) = 2.55, p < 0.01, and explained 13.7% of the variance (R2 = 0.137).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The survey completion rate was 74.0%.

    “Completion rate was 74.0%.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Care leavers are more likely to attempt suicide, abuse substances, and engage in criminal behavior.

    “Berlin and colleagues (2011) found that care leavers were more likely to attempt suicide, abuse substances, and engage in criminal behavior.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Berlin et al., 2011

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Care leavers have lower rates of post-secondary education, higher rates of unemployment or underemployment, and higher levels of poverty.

    “Other work has documented lower rates of post-secondary education, higher rates of unemployment or underemployment, and higher levels of poverty (Berejena Mhongera & Lombard, 2016; Dickens, 2018; Diraditsile & Nyadza, 2018).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Berejena Mhongera & Lombard, 2016 source

      Not checked in the free run.

    • cites Dickens, 2018 source

      Not checked in the free run.

    • cites Diraditsile & Nyadza, 2018 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Spirituality has been identified as a factor that might be related to positive outcomes.

    “In recent years, spirituality has been identified as a factor that might be related to positive outcomes (Ager et al., 2015; Bryant-Davis & Wong, 2013).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Ager et al., 2015 source

      Not checked in the free run.

    • cites Bryant-Davis & Wong, 2013 source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductcitation

    Survey instruments were available in English, Spanish, Hindi, Thai, and Bulgarian, and cross-cultural methodology guidelines proposed by Brislin (1980) were followed, including blind back-translations by bilingual experts.

    “Survey instruments were available in English, Spanish, Hindi, Thai, and Bulgarian. Cross-cultural methodology guidelines proposed by Brislin (1980) were followed. This included two bilingual experts for each language, with at least one native speaker, conducting blind back-translations, educated translations, and translating survey questions and participant responses.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Brislin, 1980 source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Spirituality serves as a factor that guides people through life challenges and functions as a pathway to resilience and maintaining well-being.

    “Spirituality seems to serve as a factor that guides people through life challenges and functions as a pathway to resilience and maintaining well-being (Manning, 2014).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Manning, 2014 source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    Two raters manually coded all open-ended questions and analyzed every question independently for references associated with faith, spirituality, and religion.

    “Two raters manually coded all open-ended questions and analyzed every question independently for references associated with faith, spirituality, and religion.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    General early adversity is linked to challenges with executive functioning, atypical behavioral development, and mental health concerns.

    “Furthermore, general early adversity has been linked to challenges with executive functioning (Lund et al., 2020), atypical behavioral development (Domoff et al., 2021; Howard et al., 2020; Ross et al., 2020; Wilke et al., 2020), and mental health concerns (Atluri et al., 2018; Pham et al., 2021).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Lund et al., 2020 source

      Not checked in the free run.

    • cites Domoff et al., 2021 source

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    • cites Atluri et al., 2018 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Care leavers are more likely to have experienced high levels of adverse childhood experiences (ACEs) and are at significantly greater risk for negative outcomes.

    “Research has consistently found that care leavers are more likely to have experienced high levels of adverse childhood experience (ACEs) and are at significantly greater risk for negative outcomes (Felitti et al., 1998; Simkiss, 2019).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Felitti et al., 1998 source

      Not checked in the free run.

    • cites Simkiss, 2019 source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Spirituality is associated with happiness, well-being, and life satisfaction.

    “Spirituality has been associated with happiness, well-being, and life satisfaction (Park et al., 2017).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Park et al., 2017 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The development of a spiritual identity has been found to be important for those with chronic physical conditions.

    “The development of a spiritual identity has been found to be important for those with chronic physical conditions (Faull & Hills, 2006).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Faull & Hills, 2006 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The current study defined spirituality, religiosity, and faith as a singular construct.

    “Furthermore, the current study defined spirituality, religiosity, and faith as a singular construct.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    The original survey was not intended to examine spirituality, and analysis was based on spontaneous spirituality references made during the open-ended questions.

    “First, the original survey was not intended to examine spirituality, and analysis was based on spontaneous spirituality references made during the open-ended questions.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Relationship to God has been demonstrated as a source of strength for children in foster care.

    “Relationship to God has been demonstrated as a source of strength for children in foster care (Jackson et al., 2010)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Jackson et al., 2010 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    Participants in the current sample might be more likely to engage in spirituality and faith practices and may not be representative of care leavers in general, because recruitment notices were distributed by an alliance for faith-based organizations.

    “recruitment notices were distributed by an alliance for faith-based organizations. As such, participants represented in the current sample might be more likely to engage in spirituality and faith practices and may not be representative of care leavers in general.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Social relationships, financial support, social environment, access to services, peer support, personal factors, and more have been shown to support better outcomes in care leavers.

    “To date, social relationships, financial support, social environment, access to services, peer support, personal factors, and more (Bryant-Davis & Wong, 2013; Frimpong-Manso, 2018; Scott et al., 2022; Sulimani-Aidan & Melkman, 2018; van Breda & Dickens, 2017) have been shown to support better outcomes in this population.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Bryant-Davis & Wong, 2013 source

      Not checked in the free run.

    • cites Frimpong-Manso, 2018 source

      Not checked in the free run.

    • cites Scott et al., 2022

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A scoping review of faith and resilience showed spiritual community support to be an important factor in positive outcomes.

    “A scoping review of faith and resilience showed spiritual community support to be an important factor in positive outcomes (Campbell & Bauer, 2021).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Campbell & Bauer, 2021

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    The current study's findings are in line with other studies showing benefit from spirituality as relates to well-being and even spirituality as a source of support in the face of adversity.

    “Although the findings of this study are preliminary in nature and require further research to confirm, they would be in line with other studies showing benefit from spirituality as relates to well-being (Ager et al., 2015; Bryant-Davis & Wong, 2013) and even spirituality as a source of support in the face of adversity (Bryant-Davis & Wong, 2013; Milner et al., 2020).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Ager et al., 2015 source

      Not checked in the free run.

    • cites Bryant-Davis & Wong, 2013 source

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    • cites Milner et al., 2020 source

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  • May combine two claims.

    Interpretationown data

    The current study's findings support the possibility that spirituality could serve as a protective factor that can potentially support care leavers through life challenges and function as a pathway to resilience and maintaining well-being.

    “Though directionality cannot be inferred in the current study, our findings support the possibility that spirituality could serve as a protective factor that can potentially support care leavers through life challenges and function as a pathway to resilience and maintaining well-being.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Taken together, findings from the current study suggest that spirituality may play an important and unique role as a factor associated with resilience, mental health, physical health, and life satisfaction among care leavers.

    “Taken together, findings from the current study suggest that spirituality may play an important and unique role as a factor associated with resilience, mental health, physical health, and life satisfaction among care leavers.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Spiritual teachings and pastoral care were highlighted as a vital support for natural disaster survivors.

    “Spiritual teachings and pastoral care were highlighted as a vital support for natural disaster survivors (Alawiyah et al., 2011).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Alawiyah et al., 2011 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Spiritual community support is valuable in humanitarian crises, during the COVID-19 pandemic, and among internally displaced persons.

    “Other research has shown spiritual community support to be valuable in humanitarian crises (Ager et al., 2015), during the COVID-19 pandemic (Wilke & Howard, 2021), and among internally displaced persons (Parsitau, 2011).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Ager et al., 2015 source

      Not checked in the free run.

    • cites Wilke & Howard, 2021 source

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    • cites Parsitau, 2011 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Relationship to God is a key support for survivors of intimate partner violence.

    “and a key support for survivors of intimate partner violence (Drumm et al., 2013).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Drumm et al., 2013 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The documented risks of having care experience are substantial and varied.

    “The documented risks of having care experience are substantial and varied (Berlin et al., 2011; Felitti et al., 1998; Simkiss, 2019).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Berlin et al., 2011

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    • cites Felitti et al., 1998 source

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    • cites Simkiss, 2019 source

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  • May combine two claims.

    Interpretationown data

    Overall, individuals who made more spirituality references reported higher levels of well-being and resilience.

    “Overall, these findings indicate that the individuals who made more spirituality references reported higher levels of well-being and resilience.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    The current sample is likely biased toward urban, educated participants with a higher socioeconomic status, and potentially more positive long-term outcomes, because participants had to have access to the internet and be literate.

    “in order to participate in the current study, participants had to have access to the internet and be literate. As a result, the current sample is likely biased toward urban, educated participants with a higher socioeconomic status, and potentially more positive long-term outcomes.”
    Quote in the paperNot a substantial claim
42 of 42

  • The paper relies on this without support.

    Little work to date has specifically examined the relationship between spirituality and outcomes in care leavers.

    “However, little research to date has specifically examined the possible relationship between spirituality and outcomes in this population.”
    “However, little work to date has specifically examined spirituality in the contexts of outcomes of adults with care experience.”

  • The paper relies on this without support.

    Spontaneous references to spirituality made in open-ended survey responses are a valid indicator of participants' spirituality.

    “Spirituality was assessed by looking at spontaneous references to spirituality made while responding to a survey examining outcomes for care leavers.”
    “Data includes spontaneous spirituality references made within the fifteen open-ended questions.”

  • The paper relies on this without support.

    No other studies have examined the relationship between spirituality and health, well-being, and resilience for care leavers.

    “However, to our knowledge, no other studies have examined relationship between spirituality and health, well-being, and resilience for care leavers.”

  • The paper relies on this without support.

    Some care leavers experience positive outcomes and greater resilience in the face of tremendous adversity.

    “However, it is clear that some care leavers experience positive outcomes and greater resilience in the face of tremendous adversity.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Meditation is associated with reduced HPA axis activation, decreased cortisol levels, and enhanced parasympathetic nervous system activity, facilitating a shift from chronic arousal to physiological calm.

    “Neurobiologically, meditation has been associated with reduced hypothalamic–pituitary–adrenal (HPA) axis activation, decreased cortisol levels, and enhanced parasympathetic nervous system activity, thereby facilitating a shift from states of chronic arousal to physiological calm (Howard et al., 2023).”

    From From use to abuse: psychological, neurobiological, and spiritual pathways in relational harm and recovery (2026) · cites this paper as Howard et al., 2023

    The Results and Discussion (page unavailable) address associations between spirituality references and care leavers’ self-reported health, not the physiological effects of meditation. Searches for meditation, HPA-axis activation, cortisol, parasympathetic activity, and chronic arousal found no passage addressing the claim. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

  • Meditation, prayer, and communal rituals are associated with modulation of stress-response systems, including reduced cortisol secretion and increased parasympathetic activity.

    “Meditation, prayer, and communal rituals have been associated with modulation of stress-response systems, including reduced cortisol secretion and increased parasympathetic activity (Howard et al., 2023).”

    From From use to abuse: psychological, neurobiological, and spiritual pathways in relational harm and recovery (2026) · cites this paper as Howard et al., 2023

    The Methods (Measures; page unavailable) include personal prayer and group faith rituals in the study’s definition of spirituality, and the Discussion (page unavailable) addresses spirituality and well-being. Neither section reports whether meditation, prayer, or rituals affect cortisol, parasympathetic activity, or other stress-response systems; searches for those physiological terms found no such passage. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

  • Emerging evidence highlights neurobiological correlates of spiritual practices.

    “Emerging evidence also highlights the neurobiological correlates of spiritual practices.”

    From From use to abuse: psychological, neurobiological, and spiritual pathways in relational harm and recovery (2026) · cites this paper as Howard et al., 2023

    The Spirituality and Discussion sections discuss associations between spirituality, resilience, and well-being, but do not address neurobiological correlates of spiritual practices. Searches for the claim’s phrase and for brain, neural, and neurobiological mechanisms found no relevant passage in our copy; page numbers were not provided. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

Statistics that don’t add up

Each reported p-value recomputed from its test statistic and degrees of freedom.

  • Inconsistent p-value across alpha = .05: F (1, 529) = 3.01, p < .01

    Major

    The paper reports p < .01 here; recomputing from the test statistic and its degrees of freedom gives p = .083. The two fall on opposite sides of alpha = .05. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p < .01 · recomputed p = .083

  • p-value fits an unstated one-tailed test: F (1, 529) = 6.14, p < .01

    Minor

    The paper reports p < .01 here; recomputing from the test statistic and its degrees of freedom gives p = .014. The reported value is what a one-tailed test gives, but the paper does not say near this result that a one-tailed test was used.

    Reported p < .01 · recomputed p = .014

  • Inconsistent p-value: F (1, 529) = 4.12, p < .01

    Minor

    The paper reports p < .01 here; recomputing from the test statistic and its degrees of freedom gives p = .043. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p < .01 · recomputed p = .043

  • Inconsistent p-value: F (7, 205) = 2.81, p < .001

    Minor

    The paper reports p < .001 here; recomputing from the test statistic and its degrees of freedom gives p = .008. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p < .001 · recomputed p = .008

  • Inconsistent p-value: F (7, 205) = 2.55, p < .01

    Minor

    The paper reports p < .01 here; recomputing from the test statistic and its degrees of freedom gives p = .015. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p < .01 · recomputed p = .015

  • Inconsistent p-value: F (1, 529) = 4.08, p < .01

    Minor

    The paper reports p < .01 here; recomputing from the test statistic and its degrees of freedom gives p = .044. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p < .01 · recomputed p = .044

  • Inconsistent p-value: F (7, 205) = 2.96, p < .001

    Minor

    The paper reports p < .001 here; recomputing from the test statistic and its degrees of freedom gives p = .006. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p < .001 · recomputed p = .006

7 of 7

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Doesn’t add upF(1, 529) = 3.01reported p < .01 · recomputed p = .083The two fall on opposite sides of .05

    “F (1, 529) = 3.01, p < .01”

  • Doesn’t add upF(1, 529) = 6.14reported p < .01 · recomputed p = .014

    “F (1, 529) = 6.14, p < .01”

  • Doesn’t add upF(1, 529) = 4.12reported p < .01 · recomputed p = .043

    “F (1, 529) = 4.12, p < .01”

  • Doesn’t add upF(1, 529) = 4.08reported p < .01 · recomputed p = .044

    “F (1, 529) = 4.08, p < .01”

  • Doesn’t add upF(7, 205) = 2.96reported p < .001 · recomputed p = .006

    “F (7, 205) = 2.96, p < .001”

  • Doesn’t add upF(7, 205) = 2.81reported p < .001 · recomputed p = .008

    “F (7, 205) = 2.81, p < .001”

  • Doesn’t add upF(7, 205) = 2.55reported p < .01 · recomputed p = .015

    “F (7, 205) = 2.55, p < .01”

  • ConsistentF(1, 529) = 23.98reported p < .01 · recomputed p < .001

    “F (1, 529) = 23.98, p < .01”

  • ConsistentF(1, 529) = 9.14reported p < .01 · recomputed p = .003

    “F (1, 529) = 9.14, p < .01”

  • ConsistentF(1, 529) = 12.97reported p < .01 · recomputed p < .001

    “F (1, 529) = 12.97, p < .01”

  • ConsistentF(1, 529) = 11.74reported p < .01 · recomputed p < .001

    “F (1, 529) = 11.74, p < .01”

  • ConsistentF(1, 529) = 10.27reported p < .01 · recomputed p = .001

    “F (1, 529) = 10.27, p < .01”

  • ConsistentF(1, 529) = 8.02reported p < .01 · recomputed p = .005

    “F (1, 529) = 8.02, p < .01”

  • ConsistentF(1, 529) = 8.62reported p < .01 · recomputed p = .003

    “F (1, 529) = 8.62, p < .01”

  • ConsistentF(7, 205) = 5.05reported p < .001 · recomputed p < .001

    “F (7, 205) = 5.05, p < .001”

15 of 15

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Claimed adjustment for gender is absent from the described MANCOVA

    Major

    The abstract says the spirituality associations persisted after accounting for gender, but the MANCOVA description lists current age, separation age, and HDI as covariates and does not include gender among its specified variables.

  • ACEs comparison uses an overlapping category label

    Minor

    The study defines its comparison groups as fewer than four versus four or more ACEs. The later comparison instead labels the lower-ACEs group "> 4," which overlaps the stated "4 +" group rather than identifying the fewer-than-four group.

  • Overall physical-health SD is incompatible with subgroup SDs

    Minor

    Table 3 gives an overall physical-health SD of 6.64. The reported subgroup sizes and SDs-including 324 participants in the no-reference group with SD 8.85-imply a larger overall SD even before differences between subgroup means are included.

  • Regression-model degrees of freedom do not match the listed predictors

    Minor

    Table 6 lists 12 predictors for 205 participants, implying model degrees of freedom of 12 and 192, not 7 and 205. Its reported F of 5.05 is consistent with 12 predictors and R2 = .240; the same F(7, 205) degrees of freedom are also reported for the other three 12-predictor models.

  • Servanthood percentage does not match its count

    Minor

    The table reports 35 participants out of 205 for spirituality-based servanthood, which is 17.1%, not 14.6%.

    Reported 14.6 · recomputed 17.073171

  • Physical-health narrative treats nonsignificant HDI as a finding

    Minor

    The results state that participants from higher-HDI nations reported better physical health, but the physical-health regression reports HDI at p = .160, not significant by the paper's p < .05 criterion.

  • Three-level spirituality factor is reported with one numerator degree of freedom

    Minor

    The spirituality-reference predictor has three categories, so its main effect requires two numerator degrees of freedom. Its reported univariate F statistics instead use one.

  • Unstarred age correlation exceeds starred correlations

    Minor

    With 529 participants, a correlation of −.50 is significant at p < .05, yet it lacks the table's significance marker. The same row marks much smaller correlations as significant.

8 of 8

Cites

Flagged first, then by citations

Research works printed but not linked: 6

  1. Berlin, L. J., Appleyard, K., & Dodge, K. A. (2011). Intergenerational continuity in child maltreatment: Mediating mechanisms and implications for prevention. Child Development, 82(1), 162–176. https://doi.org/10.1111/j.1467-8624.2010.01547 · DOI
  2. Campbell, C., & Bauer, S. (2021). Christian faith and resilience: Implications for social work practice. Social Work & Christianity, 48(1). https://doi.org/10.3403/SWC.V48I1.212 · DOI
  3. Koenig, H. (2006). In the wake of disaster: Religious responses to terrorism & catastrophe. Templeton Foundation Press.
  4. Lunn, J. (2009). The role of religion, spirituality and faith in development: A critical theory approach. Third World Quarterly, 30(5), 937–951. https://doi.org/10.1080/0143659090 · DOI
  5. Wilke, N. G., Howard, A. R. H., Todorov, S., Bautista, J., & Medefind, J. (2022). Antecedents to child placement in residential care: A systematic review. Institutionalised Children Explorations and beyond: An International Journal on Alternative Care, 9(2), 188–201. https://doi.org/10.1177/2349300322108233 · DOI
  6. Wilke, N. G., Roberts, M., Mitchell, T., & Howard, A. R. H. (In Press). Spirituality as a protective factor: A multinational study of 267 adults with care experience. Social Work & Christianity

Cited by

Sorted by citations

Related

Authors
Howard, A. H., Roberts, M., Mitchell, T., & Wilke, N. G.
Affiliations
Samford University (US)
ORCID
Wilke, Nicole Gilbertson
Venue
Adversity and Resilience Science
Publisher
Springer Science and Business Media LLC
Published
2023-02-11
Volume
4
Issue
2
Pages
177-190
ISSN
  • 2662-2416 (ISSN-L)
  • 2662-2424
DOI
10.1007/s42844-023-00088-y
PMC
PMC9918825
OpenAlex
W4320038926
Semantic Scholar
94aba48f2d9320dd3bb7bf2596419e261243b5f2
Cited by
50
References
62
Citations by year
2026: 22 · 2025: 14 · 2024: 12 · 2023: 2
FWCI
13.51
Type
journal article
Language
en
Open access
Licence
Locations
  • Adversity and Resilience Science (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
UBS Optimus Foundation
Topics
  • Social Sciences › Health › Religion, Spirituality, and Psychology
  • Social Sciences › Safety Research › Child Welfare and Adoption
  • Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
Keywords
spirituality, resilience, well-being, care leavers, foster care, life satisfaction, mental health, physical health, childhood adversity, cross-national comparison

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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