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Concerns About Measuring “Spirituality” in Research

Koenig, Harold G. MD

The Journal of Nervous and Mental Disease: May 2008 - Volume 196 - Issue 5 - p 349-355
doi: 10.1097/NMD.0b013e31816ff796
Original Article

Spirituality is increasingly being examined as a construct related to mental and physical health. The definition of spirituality, however, has been changing. Traditionally, spirituality was used to describe the deeply religious person, but it has now expanded to include the superficially religious person, the religious seeker, the seeker of well-being and happiness, and the completely secular person. Instruments used to measure spirituality reflect this trend. These measures are heavily contaminated with questions assessing positive character traits or mental health: optimism, forgiveness, gratitude, meaning and purpose in life, peacefulness, harmony, and general well-being. Spirituality, measured by indicators of good mental health, is found to be correlated with good mental health. This research has been reported in some of the world's top medical journals. Such associations are meaningless and tautological. Either spirituality should be defined and measured in traditional terms as a unique, uncontaminated construct, or it should be eliminated from use in academic research.

Department of Psychiatry and Behavioral Sciences, and Department of Medicine, Duke University Medical Center, Geriatric Research, Education and Clinical Center, VA Medical Center, Durham, North Carolina.

Send reprint requests to Harold G. Koenig, MD, Box 3400, Duke University Medical Center, Durham, NC 27710. E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.