SPIRITUALITY, RESILIENCE, AND SOCIAL SUPPORT AS PREDICTORS OF LIFE SATISFACTION IN YOUNG ADULTS WITH A HISTORY OF CHILDHOOD TRAUMA
CHAPTER I
INTRODUCTION TO THE STUDY AND REVIEW OF THE LITERATURE
Researchers have explored and documented the constructs of childhood trauma, life satisfaction, spirituality, resilience, and social support, and how these constructs are related to one another. However, there is a need to further explore how each of these factors influences life satisfaction. This chapter provides justification for the study of spirituality, resilience, and social support as predictors of life satisfaction in young adults who experienced childhood trauma. Each of the constructs is examined individually and in relation to each other. Among the constructs associated with positive outcomes in adults who experienced childhood trauma are spirituality (Galea, 2008), resilience (DuMont, Widom, & Czaja, 2007; Herringshaw, 1997), and social support (Fredrick & Goddard, 2008; Werner & Johnson, 2004). The research question for the current study is: To what extent do spirituality, resilience, and social support predict life satisfaction in young adults who experienced childhood trauma?
Introduction to the Study
Childhood trauma is defined as a painful experience or event in childhood. It includes experiences of abuse, or serious illness of an immediate family member or the self. It can include events such as witnessing violence, residing in a household where there is substance abuse or mental illness, and experiencing death of an immediate family member (Bremner, Bolus, & Mayer, 2007). Runyan et al. (2005) added that it is the perception of the event that constitutes trauma or abuse. It is not only the actual event but the person’s response to it that makes the event traumatic. Several authors link childhood
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trauma to problems long after the event ended, including anxiety, depression, and physical health problems in adulthood (Chartier, Walker, & Naimark, 2007; Macmillan, Fleming, & Streiner, 2001; Sorbo, Grimstad, Bjorngaard, Schei, & Lukasse, 2013).
Those with a history of childhood trauma are at an increased risk of long-term negative experiences. However, the focus of the current study is on persons who have experienced a positive outcome, in the form of increased life satisfaction, despite negative life situations. Life satisfaction is an individual’s overall contentment with life. Those who are more satisfied with life are both mentally and physically healthier than those with lower life satisfaction (Arrindell, Meeuwesen, & Huyse, 1991; Bigatti & Cronan, 2002; Diener, Suh, Lucas, & Smith, 1999). Adult life satisfaction remains stable over time and is influenced by early childhood experiences. Trauma during the formative years has more of a detrimental effect than trauma later in life. The experience of childhood trauma is associated with lower levels of life satisfaction in young adults over the age of 18 (Oishi & Sullivan, 2005; G. Parker et al., 1997; Singh, Manjula, & Phillip, 2012).
Childhood trauma has a negative influence on adult life satisfaction. There are protective factors, however, that serve to lessen the detrimental effects of childhood trauma. Spirituality is one of these protective factors. Spirituality is the process through which a person makes meaning and finds purpose in life (Piedmont, 1999). Persons with higher levels of spirituality also have higher levels of life satisfaction (Neimeyer, Currier, Coleman, Tomer, & Samuel, 2011). This is especially true for persons with a history of
childhood trauma. Studies suggest that the negative influence of childhood trauma on life satisfaction is tempered by spirituality (Galea, 2008; P. L. Ryan, 1998).
Like spirituality, resilience can be a protective influence for those who have experienced childhood trauma (Dumont et al., 2007). Resilience is the ability to regain a sense of normalcy after a negative life event (Miller, 2003). Higher levels of resilience have been found to lead to higher levels of life satisfaction. This is true for those who have experienced childhood trauma (Almedom, 2005).
Similar to spirituality and resilience, social support tempers the negative effects of childhood trauma and increases life satisfaction for those who have experienced childhood trauma (Siddall, Huebner, & Jiang, 2013; Siqueira, Spath, Dell’Aglio, & Koller, 2011). Shakespeare-Finch and Obst (2011) described social support as assistance that is given and received. It includes emotional support such as being a confidant to others, and providing instrumental support in the form of material items.
Multiple studies have linked childhood trauma with poor outcomes in adulthood including adult criminal behavior, depression, and unhealthy, or abusive relationships in adulthood (Chapman et al., 2004; Sorbo et al., 2013). Research also suggests that spirituality, resilience, and social support act as buffering agents to shield a person from the negative effects of trauma during the formative years. Few studies have analyzed the relationship between spirituality, resilience, and social support with respect to life satisfaction. Learning how these constructs connect is necessary to target preventive services for children who have experienced childhood trauma and to increase their adult life satisfaction (DuMont et al., 2007; Fredrick & Goddard, 2007; Galea, 2008;
Herringshaw, 1997; Pitzer & Fingerman, 2010; Werner & Johnson, 2004). The research question that guided the current study was: To what extent do spirituality, resilience, and social support predict life satisfaction in young adults who experienced childhood trauma?
This chapter provides a comprehensive overview of the relevant literature on childhood trauma, life satisfaction, spirituality, resilience, and social support. This is followed by a discussion of the purpose of the study. Chapter I ends with a conclusion and a brief introduction to Chapter 2.
Review of the Literature
The current study sought to examine spirituality, resilience, and social support as predictors of life satisfaction in young adults who experienced childhood trauma. The following sections address definitions of each construct. The literature review addresses how these constructs have traditionally been measured and the limitations associated with quantifying childhood trauma, life satisfaction, spirituality, resilience, and social support. Outcomes associated with each of the constructs are discussed.
Childhood Trauma
The following section provides definitions of the types of childhood trauma and a description of each type of trauma. Next, the outcomes associated with childhood trauma are discussed in detail. The section concludes with a summary of childhood trauma.
Defining Childhood Trauma
There are varying definitions of childhood trauma based on culture, perception, and situation. In order to connect the experience of childhood trauma with spirituality,
resilience, and social support, a set definition of childhood trauma is necessary. This section explores definitions in the current literature, calls attention to inconsistencies in definitions, and defines childhood trauma for the current study.
Childhood trauma includes experiencing physical, emotional, and sexual abuse as a child, living with a mentally ill caregiver or substance abusing caregiver, and witnessing family violence. Other examples of childhood trauma are witnessing murder, living through natural disasters, experiencing severe illness or injury, and witnessing or experiencing an accident (Bremner, Vermetten, & Mazure, 2000; Bremner et al., 2007).
Reimer (2010) described the impact of childhood trauma in the form of growing up with a mentally ill parent. She contended that it is not just the experience of having a mentally ill parent but the situations that it places a child in and the child’s perceptions of and reactions to those situations throughout a lifetime. The experience of having a mentally ill parent varies by individual but often includes physical and emotional abuse or neglect.
Childhood trauma also includes low to moderate levels of aggression directed towards a child. Seides (2010) described this as microtrauma. Microtrauma includes the experience of less severe events such as teasing, bullying, and being used as a scapegoat. Seides stated that chronic exposure to these types of events has a lasting impact and can lead to trauma-related symptomology such as anxiety, depression, and posttraumatic stress disorder (PTSD) in the same manner as a major traumatic event. Others (Seitz et al., 2011; Shmotkin & Lomranz, 1998; Tsai, Harpaz-Rotem, Pietrzak, & Southwick, 2012) contended that repeated exposure to trauma, including microtrauma, is more
detrimental to the psychological state of a person than a single occurrence of major trauma.
Runyan et al. (2005) explored the differences between theoretical and practical definitions of child abuse. They recommended clearer descriptions of child abuse and maltreatment, and greater agreement between the definitions researchers and practitioners use. They indicated there is a discrepancy between the belief of childhood abuse and the real world descriptions of childhood abuse. They argued that these terms change over time, by profession, and culture. Additionally, there is controversy over whether trauma should be demarcated in terms of the actions of the offender or the perception of these actions by the victim. A person who feels he or she experienced trauma would suffer effects from it regardless of an external source validating the trauma. In essence, a person who identifies as having experienced trauma has experienced trauma. Therefore, a self-report of childhood trauma is as valid as a quantifiable measure of childhood trauma.
For the purpose of the current study, childhood trauma includes physical abuse, emotional abuse, and sexual abuse, as well as other experiences regarded as traumatic. Physical abuse involves any action by a caregiver that causes bodily harm to a child.
Emotional abuse includes actions such as ignoring or coercive over controlling of a child and involves any behavior that psychologically harms a child. Over controlling includes threats or manipulations of a child to suit the interests of the caregiver. Sexual abuse involves any unwanted sexual contact (Hamarman, Pope, & Czaja, 2002; Paavilainen & Tarkka, 2003; Trickett, Mennen, Kim, & Sang, 2009). Other experiences considered to
be traumatic are serious illness of self or immediate family, death of an immediate family member, involvement in a situation where life or personal wellbeing is at risk, microtraumas, bullying, belittling, and witnessing or experiencing a natural disaster or accident (Bremner et al., 2000; Bremner et al., 2007).
Outcomes Associated With Childhood Trauma
Some of the negative outcomes of childhood trauma include an increased likelihood of experiencing an abusive relationship later in life, drug and alcohol abuse, poor physical health, poor mental health, sexual distress, and a predisposition to trauma later in life. However, research suggests positive experiences help to buffer the effects of childhood trauma. Without these protective experiences, negative outcomes are common (Rellini & Meston, 2007; Sorbo et al., 2013). Sorbo et al. studied the prevalence of lifetime abuse in pregnant women in Norway and found that 32% of all participants had been exposed to abuse in their lifetimes. Those who had been exposed to abuse in childhood were more likely to experience abuse in adulthood in the form of intimate partner violence, than those who had not been exposed to childhood abuse.
Rellini and Meston (2007) found that women who experienced sexual abuse in childhood had higher rates of sexual distress, including anxiety and avoidance of sexual activity, than those who did not experience sexual abuse. Additionally, Banyard and Williams (2007) found that women who experienced sexual abuse in childhood were more likely to experience substance abuse and were predisposed to revictimization later in life. This research was based on follow-up with women who had participated in treatment for substance abuse issues.
There appears to be a strong link between adverse childhood experiences and poor mental and physical health. This association is found across all types of childhood trauma (Norman et al., 2012). Chartier et al. (2007) found that those who experienced abuse or neglect also experienced more health problems in adulthood, including more frequent physician visits, emergency room visits, and reports of physical pain.
This association also extends to mental health. Macmillan et al. (2001) found a relationship between childhood trauma, poor mental health, and suicide in adulthood. Comparable to the findings of Macmillan et al., other researchers found similar connections between childhood trauma and adult mental illness. Chapman et al. (2004) and Hovens et al. (2010) reported that those with a history of childhood trauma were more likely to experience depression and anxiety in adulthood.
Research suggests that depression and anxiety are not uncommon in those who have experienced childhood trauma, with onset in adolescence and young adulthood. A study of suicidal actions in Korean college students who experienced childhood trauma (Jeon et al., 2009) found a correlation between suicidal behavior and early childhood trauma. College students were rated on suicidal ideation, attempt, and plan. High suicidality scores correlated with several types of trauma including all types of child abuse and general childhood trauma. Results suggest that trauma in childhood increases suicidal behavior in adulthood. Those who experienced emotional abuse were more likely to engage in suicidal behavior than those who experienced physical abuse, sexual abuse, or general trauma.
Sachs-Ericsson, Verona, Joiner, and Preacher (2006) studied abuse and subsequent internalizing disorders, such as depression and anxiety. All forms of abuse correlated with internalizing disorders. It was found that verbal abuse leads to
self-criticism resulting in internalizing disorders. Those who experienced verbal abuse reported a higher level of internalizing disorders when compared to other types of childhood abuse. Their interpretation is that those who experience verbal abuse are more likely to accept abusive statements as truths and be more self-critical than those without a history of verbal abuse.
Section Summary
The effects of childhood trauma go beyond the individual and affect society as a whole. The experience of childhood trauma has lasting effects into adulthood.
Childhood trauma has been associated with lower levels of achievement and education. Those with a history of trauma are less likely to finish high school and those who do finish are less likely to go on to college. Persons who report a history of childhood trauma also have poor mental health. This group experiences higher rates of depression, suicide, and anxiety than the general population (Gilbert et al., 2009; Macmillan et al., 2001).
Poor physical health is seen in adults who have experienced trauma in childhood.
This population experiences more frequent emergency room visits, and higher rates of chronic illnesses than the general population (Chapman et al., 2004). Violent criminal behaviors have been associated with childhood trauma. Persons who experienced violence in the home are more likely to initiate intimate partner violence and become
involved in armed robberies (Mannon & Leitschuh, 2002). From this review of the relevant literature, there is a wealth of evidence to support negative outcomes with those who have experienced childhood trauma.
Life Satisfaction
The following section provides a definition of life satisfaction and the outcomes associated with it. Factors influencing life satisfaction are described in detail. The section ends with a discussion of the stability of the construct of life satisfaction.
Defining Life Satisfaction
Life satisfaction is a subjective construct and is defined as a level of contentment with life that remains stable over time. A level of life satisfaction depends on a person’s feelings about life circumstances and not on the actual condition of a person’s life.
However, situations such as poor physical health or mental distress do contribute to changes in life satisfaction. These factors vary based on class, culture, personal belief system, and within members of the same population (Pavot & Diener, 2008).
Gamble and Gärling (2012) distinguished between the constructs of current mood, happiness, and life satisfaction. They administered the Satisfaction with Life Scale (SWLS; Diener, Emmons, Larsen, & Griffin, 1985) to undergraduate students. Based on the results of the study, Gamble and Gärling (2012) hypothesized happiness is a situationally derived concept that is influenced by goal attainment, whereas life satisfaction is stable in adults over time. Life satisfaction is influenced by a number of factors including negative life situations, particularly in the formative years. Life
satisfaction stabilizes within an individual as early as late adolescence and young adulthood (Diener et al., 1985; Pavot & Diener, 2008).
Outcomes Associated With Life Satisfaction
Previous studies demonstrated that persons who are highly satisfied with life are happier and have better health outcomes than persons with lower levels of life satisfaction. Arrindell, van Nieuwenhuizen, and Luteijn (2001) studied life satisfaction in persons with mental health diagnoses. They found a positive relationship between a supportive partnership and increased life satisfaction. Although those with chronic mental health conditions had slightly lower scores on the SWLS, they were still within the typical range, indicating life satisfaction is consistent, rather than fluctuating.
It seems, therefore that life situations have little impact on the overall satisfaction with life score. Pavot and Diener (2008) described this as stable and sensitive nature of the SWLS. This means that life satisfaction is a stable construct from late adolescence throughout adulthood, yet positive events such as counseling and negative events such as long term illness, influence scores on the SWLS. For example, if a person scores in the “slight dissatisfaction with life” range with a score between 15 and 19, counseling may positively influence their life satisfaction to “slight satisfaction with life” range with a score between 21 and 25; however it is unlikely their scores will increase to “extreme satisfaction with life” or drop to “extreme dissatisfaction with life.” Some of the factors that contributed to an increase in scores in study participants were level of education, age, and a supportive partnership (Arrindell et al., 2001).
Spirituality
The following section provides a definition of spirituality and describes the details of it, including a discussion of the separateness of spirituality from other measures of personality. Next, the differences between spirituality and religiosity are explored. The section concludes with a discussion of the outcomes associated with spirituality.
Defining Spirituality
Spirituality has an important and individualized role in the overall well-being of a person. The way in which spirituality is experienced is unique for each person. Those with higher reported levels of spirituality have experienced positive benefits including better mental health (Maltby & Day, 2004) and better physical health (Connor, Davidson, & Lee, 2003).
It is important to understand two key concepts: spirituality and religiosity.
Spirituality is an inclusive term boundless of any religious orientation or denomination: It is viewed as a motivating trait that remains stable over time. It inspires people to seek positive interactions for the benefit of others. Piedmont (2001) defined spirituality as “an individual’s efforts to construe a broad sense of personal meaning within an eschatological context” (p. 5). Essentially this means humans are aware of their own mortality and therefore they strive to create a sense of meaning, purpose, and fulfillment.
Similar to the concept of spirituality is religiosity. Religiosity is defined as involvement in organized religion and the conviction of religious beliefs. It is related to religious motivation, or the drive to live out a pious life, and is categorized as intrinsic or extrinsic, a distinction that is important (Maltby & Day, 2004). Persons with extrinsic
religious motivation become and remain involved with religion because of an external reward such as social status, connection, or protection. Persons with intrinsic religious motivation are encouraged in their beliefs based on internal feelings of peace and tranquility.
Studies of spirituality and religiosity have found that persons define spirituality and religiosity as separate constructs. Participants in P. L. Ryan’s (1998) study were clear that they were spiritual but not religious. Galea (2008) pointed out the differences between being religious and being spiritual. He defined spirituality as a personal experience and religion as involvement in an organized group of people. This distinction is important because previous studies (Galea, 2008; P. L. Ryan, 1998) showed that religiosity has a negative impact on young adult survivors of abuse. Many abuse survivors have felt ostracized by their religious community or have been told by religious officials that the abuse was punishment for some offense they committed, which may explain negative feelings towards religion.
The spiritual wellbeing and practices of young adults with a history of childhood trauma have been widely studied. Those who have experienced abuse often view religiosity negatively. Typically, the individual feels further victimized by persons in the organized religion. However, spirituality is viewed as an individual experience that engages a person in a process of search for meaning and purpose; it is associated with improved health and increased wellbeing (Galea, 2008; P. L. Ryan, 1998).
Spiritual transcendence is a component of spirituality and is defined as “the capacity of individuals to stand outside of their immediate sense of time and place and to
view life from a larger more objective perspective” (Piedmont, 1999, p. 988). This means that persons are able to view situations and the impact of behaviors of themselves and others in an unselfish way. Spiritual transcendence involves intrinsic religious motivation; it transcends religion, time, and place, and encompasses the constructs of prayer fulfillment, universality, and connectedness. In essence, spiritual transcendence is the component of spirituality that is the same for all people regardless of culture or religious affiliation. The way in which spirituality manifests itself is different for individuals over time but its underpinning components remain unchanged (Piedmont, 1999).
Prayer fulfillment involves actions, practices, and feelings of peace from an encounter with a higher power. This could involve prayer, meditation, reflection, or other similar behavior. Universality refers to the belief that all people share a common link. It is a sense of togetherness, a belief that although one is not responsible for another’s actions, one person’s actions have consequences for all. Connectedness is the belief that all humans share a similar reality and are connected across time and space.
Connectedness differs from universality in that universality refers to relations among beings in the current time and place whereas connectedness is bonding with all humans who have died and those who have yet to be born. For the purpose of the current study, spirituality is defined as a person’s ability to create meaning through feelings, actions, and practices of connection and unity with all living things (Piedmont, 1999).
Those who oppose spirituality as a psychometrically measurable construct argue that spirituality is not measurable and scales that attempt to measure it are actually
measuring other aspects of personality. Piedmont’s (2004) research suggested that spirituality is a measureable construct and is a dimension of the person that cannot be measured by other instruments. He further asserted that spirituality should be considered to understand a person as a whole. Based on research, Piedmont (1999, 2001) was able to demonstrate the separateness of the construct from other psychological constructs such as those represented in the Five Factor Model of Personality (McCrae & John, 1992): Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness. It is important to understand spirituality as a unique and measurable component of a person when studying the effects of it on other measurable constructs.
Outcomes Associated With Spirituality
Spirituality has been associated with many positive outcomes. Among these are lower levels of suicidal ideation (Kyle, 2013) and lower levels of anxiety (Narimani, Babolan, & Ariapooran, 2011). Spirituality has also been associated with positive outcomes for those who are in recovery from substance addiction (Piedmont, 2004).
Overall, spirituality appears to provide a buffer to difficulty. The following section provides a review of relevant literature to further illustrate this association.
In a recent study on the role of spirituality as a mediating factor in suicide in young adults, Kyle (2013) found that those with higher levels of spiritual wellbeing had lower rates of suicidal ideation. Additionally, it was found that higher levels of social support led to a decreased risk for suicidal ideation. The population surveyed included traditional college students from a non-clinical population. It was found that social support, spiritual wellbeing, and reasons for living were negatively correlated with risk
for suicide. This suggests that each of these factors is important to the psychological wellbeing of an individual (Kyle, 2013).
Narimani et al. (2011) studied spirituality, competitive anxiety, and self- confidence in college athletes. Competitive anxiety is defined as debilitating apprehension prior to athletic performance. Those who held a general belief that their prayers were fulfilled and felt connected with others, two aspects of spirituality, reported lower levels of anxiety and had fewer stress related illnesses such as headache or muscle ache and had higher levels of self-confidence when compared to those who did not believe in prayer (Narimani et al., 2011).
Spirituality is also linked to positive outcomes in men and women who participated in an 8-week program for recovery from substance abuse (Piedmont, 2004). Those with higher scores on prayer fulfillment, connectedness, and universality were more likely to sustain changes made in treatment. In this study, the Assessment of Spirituality and Religious Sentiments (ASPIRES; Piedmont, 1999) was administered to participants at pre-treatment and post-treatment. Scores on the measure remained stable over time, providing evidence to support the assertion that spirituality is an aspect of personality (Piedmont, 2004) and is stable within an individual over time (Piedmont, 1999, 2001).
The positive effects of spirituality in young adults have been well demonstrated. Spirituality is associated with lower levels of suicidal ideation (Kyle, 2013), lower levels of competitive anxiety, and higher levels of self-confidence (Narimani et al., 2011), and
positive psychological functioning (Piedmont, 2004). Spirituality appears to provide protection from depression, anxiety, and suicidal ideation as early as young adulthood.
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