Many people experience struggle around religious and spiritual aspects of life, as shown in a steadily growing body of research. A need now exists for more comprehensive, reliable, concise measurement of religious and spiritual (r/s) struggles through a scale that covers multiple domains. This article describes the development and initial validation of a 26-item measure, the Religious and Spiritual Struggles (RSS) Scale. The measure assesses six domains of r/s struggle: divine (negative emotion centered on beliefs about God or a perceived relationship with God), demonic (concern that the devil or evil spirits are attacking an individual or causing negative events), interpersonal (concern about negative experiences with religious people or institutions; interpersonal conflict around religious issues), moral (wrestling with attempts to follow moral principles; worry or guilt about perceived offenses by the self), doubt (feeling troubled by doubts or questions about one's r/s beliefs), and ultimate meaning (concern about not perceiving deep meaning in one's life). Study 1 used factor analytic techniques in two adult samples (Ns ϭ 400 and 483) to refine the item pool for the RSS. Study 2, which sampled 1141 undergraduates, showed very good fit for a six-factor model using confirmatory factor analysis. Study 2 also provided evidence of convergent, discriminant and predictive validity by relating RSS scores to measures of religiousness, r/s struggle and mental health. Several potentially important demographic differences emerged on the RSS. For example, undergraduates without committed romantic relationships and those who self-identified as homosexual reported greater r/s struggles across multiple domains.

Socioeconomic status (SES) is an important predictor of a range of health and illness outcomes. Research seeking to identify the extent to which this often-reported effect is due to protective benefits of higher SES or to toxic elements of lower social status has not yielded consistent or conclusive findings. A relatively novel hypothesis is that these effects are due to chronic stress that is associated with SES; lower SES is reliably associated with a number of important social and environmental conditions that contribute to chronic stress burden, including crowding, crime, noise pollution, discrimination, and other hazards or stressors. In other words, chronic stress may capture much of the variance in health and social outcomes associated with harmful aspects of lower social status. Low SES is generally associated with distress, prevalence of mental health problems, and with health-impairing behaviors that are also related to stress. Research targeting this hypothesis is needed to determine the extent to which stress is a pathway linking SES and health.

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The association between coping and pregnancy-specific distress was examined in 167 pregnant women at high medical risk. A population-appropriate coping inventory and prenatal distress measure were administered in mid-pregnancy (mean of 24 weeks gestation). Subjects experienced moderately high levels of distress about preterm delivery, physical symptoms, labor and delivery, weight gain, and having an unhealthy baby. They most frequently coped with the demands and challenges of pregnancy through prayer and positive appraisal. Sociodemographic variables including age, income, education, and parity were significantly associated with ways of coping. Coping by avoidance, preparation for motherhood, and substance use were associated with greater distress, whereas coping by positive appraisal was associated with less distress. These effects differed somewhat when levels of global, non-specific distress were controlled. Findings underscore the unique nature of high-risk pregnancy as a stressful life event.