The Role of Private Religious Practices, Spiritual Mindfulness, and Years since Loss on Perceived Growth in Widowed Adults

Abstract

Private religiosity can lead to perceived growth after bereavement, but little is known about the role of mindfulness and the time since loss in widowed adults. Using data from the second panel of the Midlife in the United States study (MIDUS), this study examined adults (n = 250) who were married one time and became widowed. Results showed that spiritual mindfulness moderated the effect of private religious practices on personal growth, and that the association between spiritual mindfulness and positive reinterpretation was moderated by time since loss. A high level of spiritual mindfulness seems to benefit widowed adults’ personal growth and positive reinterpretation. Additionally, the greater time since loss the more positive is the association between mindfulness and positive reinterpretation. No difference was found in means between widowed adults and a matched control group of non-widowed adults (n = 250) on personal growth and positive reinterpretation.

The loss of one’s spouse is an extremely difficult experience for most individuals and grieving can take a long time. Widowhood is more common in older adulthood and is among the most distressing life events (e.g., King, Carr, & Taylor, 2018; Utz, Caserta, & Lund, 2011). In the U.S., among people 75 years and over, 14.7 percent of men and 42.9 percent of women are widowed (Roberts, Ogunwole, Blakeslee, & Rabe, 2018). Widowhood and corresponding bereavement is often accompanied by changes in many aspects of life (e.g., daily routines, emotional support) and can result in increased morbidity and mortality (e.g., Moon, Kondo, Glymour & Subramanian, 2011; Stroebe, Schut, & Stroebe, 2007; Wilcox et al., 2003). Research on whether women or men are better equipped to deal with marital loss show mixed results and arguments have been made in either way (Onrust & Cuijpers, 2006; Stroebe, Stroebe, & Schut, 2001, for a review). In widowhood, posttraumatic or perceived growth may be important because it has been associated with positive health outcomes in older adults (e.g., Heckhausen, 2001). Although research has investigated the role of private religiousness on perceived growth (e.g., Shaw et al., 2005), we are not aware of any study that has investigated the role of spiritual mindfulness on perceived growth in widowhood. This oversight is meaningful because mindfulness can be purposefully modified (e.g., Kabat-Zinn, 2005), and there is evidence that spirituality may promote or enable growth in the context of a stressful event (Hill & Pargament, 2003). Also, little is known about the effect of time since loss of a spouse and perceived growth. The current study seeks to contribute to a better understanding of the role of private religious practices, spiritual mindfulness, and the time since loss on perceived growth in widowed adults.

Perceived growth

Despite the emotional difficulty of losing a spouse, widowhood can also create opportunities for personal growth. This phenomenon has been called posttraumatic growth (Tedeschi & Calhoun, 1995, 2004) or stress-related growth (Park, Cohen, & Murch, 1996) and is frequently attributed to changes in coping mechanisms, such as positive reinterpretation (Scheier, Weintraub, & Carver, 1986). For posttraumatic growth to occur, Calhoun, Tedeschi, Cann, and Hanks (2010) proposed that the loss needs to disrupt previously held assumptions about the world (e.g., seeing things as reliable, predictable, and controllable) and initiate a process of rebuilding those beliefs to provide meaning or an explanation of the loss. Hence, the process of rebuilding can result in perceptions that one has grown through the loss (Calhoun et al., 2010; Janoff-Bulman, 2004; Park, 2010; Tedeschi & Calhoun, 2004).

Spirituality

There is evidence that posttraumatic growth is possible after different types of bereavement, such as the loss of a child or a loved one (Davis, Wohl, & Verberg, 2007; Engelkemeyer & Marwit, 2008; Matthews & Servaty-Seib, 2007), and that spirituality or religiousness may facilitate personal growth (Hill & Pargament, 2003; Koenig, 2009; Matthews & Marwit, 2006; Michael, Crowther, Schmid, & Allen, 2003). A review of 11 studies investigating the relationship between religion, spirituality, and posttraumatic growth in people who had experienced trauma found that private or intrinsic religiousness, which refers to solitary activities such as praying, meditating and bible reading (e.g., Neil & Kahn, 1999), was associated with posttraumatic growth (Shaw, Joseph, & Linely, 2005). Wortman and Park (2008) conducted a systematic review of 73 articles on religion/spirituality in the context of bereavement. They found that religion/spirituality generally had a positive effect on adjustment to bereavement, though the results were inconsistent and varied depending on how religion/spirituality was measured. Caserta at al. (2009) studied recently bereaved partners (2–6 months since loss) and found that 21 percent of the sample experienced moderate to high levels of growth relative to the sample mean. Moreover, stress-related growth was more likely for those who described themselves as more religious.

Mindfulness

Mindfulness offers another way to cope with stress after the loss of one’s spouse. “Mindfulness is what brings us back in touch with what’s happening in the present moment in our body, in our feelings, in our thinking, and also in our environment” (Hanh, 2012, p. 9). As pointed out by Kabat-Zinn (2005), mindfulness does not diminish our pain, but does create a greater capacity to hold and tolerate emotional pain that may lead to personal growth and transformation. In line with this, Thieleman, Cacciatore, and Hill (2014) found a significant decline in trauma, anxiety, and depressive symptoms after an average of 14.6 hours of mindfulness-based intervention in 42 clients seeking grief counseling.

Time since loss

Although there seems to be no typical course for grief resolution (Bonanno, 2009), the intensity and frequency of grief-related distress tends to abate with time, and most individuals return to normal functioning within two years (Bonanno, 2005; Coifman & Bonanno, 2010). For example, Hagedoorn et al. (2006) reported that those widowed in the previous two years were the only widows who reported more distress than married people, whereas after two years married and widowed peoples’ distress did not differ. A study by Lucas, Clark, Georgellis, and Diener (2003) found that widowed people came closest to their pre-loss levels of satisfaction after eight years. Tedeschi and Calhoun (2004) mentioned that many people who survive traumatic events report a sense of disbelief or distress months later, and that this process over time may be necessary for posttraumatic growth. Evidence suggests that longer time since loss is associated with more growth in bereaved parents (Engelkemeyer & Marwit, 2008), suicide survivors (Drapeau, Lockman, Moore, & Cerel, 2019), and individuals who lost first degree relatives or a romantic partner (Yilmaz & Zara, 2016).

Age and Gender

Experiences during bereavement and potential factors for posttraumatic growth may differ across age and gender. For instance, López, Camilli, and Noriega (2015) found in a sample of 103 older people aged 65 or more that age was negatively related with posttraumatic growth, whereas another study of 464 adults whose average age was 60 years reported that older bereaved people showed greater resilience (Mancini, Bonanno, & Clark, 2011). With regard to gender, it has been argued that widows are more likely to experience growth than widowers because spousal loss is more normative in women and they have larger support networks than men (Wortman, 2004; López et al., 2015). On the other hand, it has been argued that men are more likely to experience growth than women because the event is more challenging and, thus, requires more adaptation, which can be a pathway to growth (Tedeschi & Calhoun, 1995, 2004). Consistent with these equally viable views, Caserta, Lund, Utz, and de Vries (2009) reported no gender differences in stress-related growth in a sample of 292 recently bereaved partners, aged 50 years and older.

The Present Study

Based on findings from previous studies (e.g., Caserta et al., 2009; Hagedoorn et al., 2006; Thieleman et al., 2014; Wortman & Park, 2008), we hypothesized that higher levels of private religious practices, higher levels of spiritual mindfulness, and longer time since loss would predict both higher levels of personal growth and positive reinterpretation after controlling for age, education, and gender. Regarding the moderating role of spiritual mindfulness and time since loss, we expected that both, high mindfulness and longer time since loss, have an enhancing effect on the association between private religious practices and the two outcomes personal growth and positive reinterpretation. Due to inconsistent results in previous research, we did not formulate specific hypotheses related to age and gender. Furthermore, we examined whether widowed adults differed in means from a matched control group of non-widowed adults.

Method

Participants

Data were derived from the second wave of the Midlife in the United States national study of health and well-being from 2004 to 2006 (MIDUS-II; Ryff et al., 2017). A sample of English-speaking adults (n = 7,108) aged 25 to 74 years were recruited via random digit dialing at MIDUS I from 1995 to 1996. Of these, 4,963 participated in MIDUS II by completing both the telephone interview and self-administered questionnaires. The participants selected for this study self-reported at MIDUS II to be widowed (“Are you married, separated, divorced, widowed, or never married?”) and married once (“How many times have you been married altogether?”), resulting in a sample size of 251 widowed adults. A matched control group of 250 non-widowed, married adults was selected using the statistical program R and the package MatchIt (Ho, Imai, King, & Stuart, 2011). We used nearest neighbor matching, which selects the best matches for each individual in the widowed group using a logistic regression model to estimate the propensity score for each individual. Specifically, individuals who self-reported at MIDUS II to be married once were matched with regard to gender, age, and educational attainment with the widowed sample. One participant of the widowed sample was excluded from the analysis due to missing data on the matching variables resulting in a sample size of 250 widowed individuals.

Procedure and Measures

Education.

The participants were asked to indicate their highest grade of completed education (“What is the highest grade of school or year of college you completed?) on a scale ranging from 1 to 12 with higher scores indicating higher levels of education (1 = “no school/some grade school”, 2 = “eighth grade/junior high school”, 3 = “some high school”, 4 = “GED”, 5 = “graduated from high school”, 6 = “1 to 2 years of college, no degree yet”, 7 = “3 or more years of college, no degree yet”, 8 = “graduated from a two-year college or vocational school, or associate’s degree”, 9 = “graduated from a four- or five-year college, or bachelor’s degree”, 10 = “some graduate school”, 11 = “master’s degree”, 12 = “PH.D., ED.D., MD, DDS, LLB, LLD, JD, or other professional degree”).

Financial situation.

The participants were inquired to rate their current financial situation on a scale ranging from “worst” (0) to “best” (10). The question was: “How would you rate your financial situation these days?”.

Social support.

Social support was measured for two domains, family support and friend support. Each participant was asked to indicate how much support he or she receives from family members or friends on a scale ranging from “a lot” (1) to “not at all” (4). The four items for family support were: “Not including your spouse or partner, how much do members of your family really care about you?”, “How much do they understand the way you feel about things?”, “How much can you rely on them for help if you have a serious problem?”, and “How much can you open up to them if you need to talk about your worries?”. The four items for friend support were: “How much do your friends really care about you?”, “How much do they understand the way you feel about things?”, “How much can you rely on them for help if you have a serious problem?”, and “How much can you open up to them if you need to talk about your worries?”. All items were reverse-coded and a mean score was calculated so that higher scores indicate greater support (Cronbach’s alphas were .83 for family support and .83 for friend support, respectively).

Health.

Participants rated their general physical and mental health on a scale ranging from “excellent” (1) to “poor” (5). Each was measured by a single item: “In general, would you say your physical health is excellent, very good, good, fair, or poor?” and “Would you say your mental or emotional health is excellent, very good, good, fair, or poor?”. The two items were reverse-coded so that higher scores indicate better physical and mental health, respectively.

Private religious practices.

Private religious practices were measured by three self-report questions, each with a 6-point response option ranging from “once a day or more” (1) to “never” (6). The items were: “Pray in private?”, “Meditate or chant?”. “Read the Bible or other religious literature?”. All items were reverse-coded and summed so that higher scores indicate more use of private religious practices (Cronbach’s α = .72).

Spiritual mindfulness.

Spiritual mindfulness was measured by nine self-report questions following Langer and Moldoveanu’s (2000) conceptualization of mindfulness. The participants were asked to rate to what extent they agreed to each statement because of their religion or spirituality on a 5-point rating scale ranging from “strongly agree” (1) to “strongly disagree” (5). “Because of your religion or spirituality, do you try to be “more engaged in the present moment”, “more sensitive to the feelings of others”, “more receptive to new ideas”, “a better listener”, “a more patient person”, “more aware of small changes in my environment”, “more tolerant of differences”, “more aware of different ways to solve problems”, and “more likely to perceive things in new ways.” The items were reverse-coded and summed so that higher scores indicate greater mindfulness (Cronbach’s α = .92).

Personal growth.

Personal growth was measured with 7-items from the 20-item Psychological Well-Being Subscale Personal Growth developed by Ryff (1989). Participants were asked to indicate their level of agreement on a 7-point scale from “strongly agree” (1) to “strongly disagree” (7). The items were: “I am not interested in activities that will expand my horizons”, “I think it is important to have new experiences that challenge how you think about yourself and the world (R)”, “When I think about it, I haven’t really improved much as a person over the years”, “I have the sense that I have developed a lot as a person over time (R)”, “For me, life has been a continuous process of learning, changing, and growth (R)”, “I gave up trying to make big improvements or changes in my life a long time ago”, and “I do not enjoy being in new situations that require me to change my old familiar ways of doing things.” The items marked with (R) were reverse-coded and summed so that higher scores indicate greater personal growth (Cronbach’s α = .68).

Positive reinterpretation.

The COPE Inventory Positive Reinterpretation and Growth Subscale, developed by Carver, Scheier, and Weintraub (1989), was used. Participants were asked to indicate what they usually do when they experience a stressful event on a 4-point rating scale ranging from “A lot” (1) to “Not at all” (4). The subscale consists of 4 items (e.g., “I look for something good in what is happening”). All items were reverse-coded and summed so that higher scores indicate greater positive reinterpretation and growth (Cronbach’s α =.73).

Statistical Analysis

Ordinary least squares (OLS) regression analysis and SPSS (IBM Corp. Released, 2016) were used to assess the moderating role of spiritual mindfulness in widowed adults. Two cross-sectional models were estimated both using private religious practices as predictor for personal growth (model 1) and for positive reinterpretation (model 2). In addition, a continuous variable measuring the years since loss of spouse was included as a second moderator. This variable was created on the information provided by the participants at MIDUS II about their year of birth and the year when the spouse died. The predictor and moderator variables were mean-centered prior to the analyses and then multiplied to form the interaction terms. We controlled for participants’ age, educational attainment, and gender. Significant interactions were plotted separately for personal growth and positive reinterpretation.

Results

Preliminary Analysis

Table 1 presents the product-moment correlations among the study variables and the descriptive statistics for the widowed and non-widowed samples separately. All substantial correlations, except for one, were between small and medium in size and were positive. The exception was the correlation of age with personal growth, which was negative in both samples. Widowed and matched non-widowed adults were similar, by design, in terms of gender, age, and educational attainment. Of the 250 widowed adults, 42 (16.8%) were male and 208 (83.2%) were female. Of the 250 non-widowed adults, 41 (16.4%) were male and 209 (83.6%) were female. Mean age was 70 years for both (SD = 9.96 for the widowed and SD = 9.46 for the non-widowed) and mean education was 6 (SD = 2.45 for the widowed and SD = 2.26 for the non-widowed) referring to 1 to 2 years of college.

Table 1.

Correlations, means, standard deviations, and empirical ranges for the study variables

Variable	1	2	3	4	5	6	7
1. Age	-	−.07	.19**	.14*	-	−.19**	−.06
2. Education	−.08	-	.04	.20**	-	.21**	.04
3. Religious Practices	.09	.02	-	35***	-	.16*	.20**
4. Spiritual Mindfulness	.10	.05	.43***	-	-	.20**	.39***
5. Years Since Loss	.26***	−.07	.02	−.07	-	-	-
6. Personal Growth	−.15*	.33***	.09	.21**	−.03	-	.38***
7. Positive Reinterpretation	−.06	.13	22**	.37***	−.01	.44***	-
Widowed
M	70.47	6.05	11.59	35.35	11.58	36.65	12.32
SD	9.96	2.45	4.46	5.13	9.88	6.89	2.36
Range	35–84	1–12	3–18	18–45	−1–49	16–49	6–16
Non-widowed
M	70.06	6.14	11.09	35.17	-	36.70	12.45
SD	9.46	2.26	4.40	5.38	-	7.26	2.04
Range	35–83	2–12	3–18	9–45	-	18–49	6.7–16
t-test
t(df)	−0.47(498)	0.42(498)	−1.17(424)	−0.36(421)	-	0.07(433)	0.63(413)
Cohen’s d	−0.04	0.04	−0.11	−0.04	-	0.01	0.06

Note. The correlations for the non-widowed sample are shown above and for the widowed sample below the diagonal. M = Mean, SD = Standard deviation. Possible ranges: 1–12 for highest level of education (1 = no school/some grade school, 12 = Ph.D., M.D., or other professional degree), 3–18 for religious practices, 9–45 for spiritual mindfulness, 7–49 for personal growth, 4–16 for positive reinterpretation and growth. The t-test indicates that there were no significant differences between the two groups.

^*p < .05.

^**p < .01.

^***p < .001 (2-tailed).

The widowed and non-widowed samples did not statistically differ on their current financial situation (M = 6.36, SD = 2.31 for the widowed and M = 6.73, SD = 2.18 for the non-widowed, t(415)= 1.68). Also, no differences between the two groups for family and friend support were observed (family support: M = 3.63, SD = 0.52 for the widowed and M = 3.66, SD = 0.52 for the non-widowed, t(433)= 0.69; friend support: M = 3.29, SD = 0.61 for the widowed and M = 3.34, SD = 0.61 for the non-widowed, t(431)= 0.77). Furthermore, the two samples did not differ in terms of their physical and mental health (physical health: M = 3.18, SD = 1.08 for the widowed and M = 3.17, SD = 1.09 for the non-widowed, t(497)= 0.17; mental health: M = 3.54, SD = 0.93 for the widowed and M = 3.62, SD = 0.95 for the non-widowed, t(498)= −1.05). Finally, the t-tests indicated that there were no significant differences between the widowed and non-widowed samples on any study variable.

Main Analyses

Personal growth.

As expected, greater spiritual mindfulness was associated with greater personal growth (Table 2). Further, the interaction effect for religious practices and spiritual mindfulness was statistically significant, indicating that the association between religious practices and personal growth was moderated by the level of mindfulness. Figure 1 illustrates the relationship between religious practices and personal growth for low spiritual mindfulness, defined as the mean minus 1 SD (i.e., −5.12), and high spiritual mindfulness, defined as the mean plus one SD (i.e., 5.12). Personal growth was high if both religious practices and mindfulness were high and low if religious practices were high and mindfulness was low. The control variables age and education were statistically significant, revealing that the younger the individual and the higher the level of completed education the higher the personal growth. However, gender did not predict personal growth. The total explained variance was 23 percent, F(10, 187) = 5.62, p < .001.

Table 2.

Regression analysis for the widowed adults

	Personal Growth		Positive Reinterpretation
Predictor	b	SE	b	SE
Age	−0.13**	0.05	−0.02	0.02
Education	0.88***	0.18	0.08	0.06
Gender	1.38	1.28	−0.08	0.44
Religious Practices (RP)	0.07	0.11	0.05	0.04
Spiritual Mindfulness (M)	0.32**	0.10	0.17***	0.03
Years Since Loss (YSL)	0.03	0.06	0.01	0.02
RP × M	0.05*	0.02	0.01	0.01
RP × YSL	0.00	0.01	0.01	0.00
M × YSL	−0.01	0.01	−0.01*	0.00
RP × M × YSL	0.00	0.00	0.00	0.00
Intercept	37.25***	4.52	13.50***	1.55
R2	.23***		.20***

Note. Religious practices, Spiritual mindfulness, and Years since loss were mean-centered prior to the analyses. F(10, 187) = 5.62 for personal growth and F(10, 183) = 4.63 for positive reinterpretation.

^*p < .05.

^**p < .01.

^***p < .001 (2-tailed).

Figure 1.

Regression lines of the widowed adults showing the moderating effect of spiritual mindfulness and time since loss on the relationship between religious practices and personal growth and positive reinterpretation, respectively.

Positive reinterpretation.

As hypothesized, greater spiritual mindfulness was associated with more positive reinterpretation (Table 2). Further, the interaction effect for mindfulness and years since loss was statistically significant, indicating that the association between spiritual mindfulness and positive reinterpretation was moderated by the number of years since the loss. Figure 1 illustrates the relationship between spiritual mindfulness and positive reinterpretation for a short time and long time since the loss, defined as the mean minus 1 SD (i.e., −9.89) and the mean plus one SD (i.e., 9.89), respectively. Positive reinterpretation was high if either mindfulness was high or the time since the loss was long. Positive reinterpretation was low if mindfulness was low and the time since loss was short. None of the control variables was statistically significant. The total explained variance was 20 percent, F(10, 183) = 4.63, p < .001.

Discussion

The current study aimed to examine the role of private religious practices, spiritual mindfulness, and years since spousal loss on perceived growth in widowed older adults, above and beyond age, educational attainment, and gender. The findings suggest that a high level of spiritual mindfulness may promote personal growth and positive reinterpretation. Specifically, personal growth was highest when both religious practices and spiritual mindfulness were high. It was lowest when religious practice was high and spiritual mindfulness was low. Positive reinterpretation was highest when spiritual mindfulness was high and the duration of partner loss was greater.

The present findings add to previous research about the role of intrinsic or private religiosity on perceived growth (Shaw et al., 2005). However, contrary to the study by Caserta et al. (2009), we did not find that private religious practices predicted growth in our model with spiritual mindfulness and time since loss as predictors and the interactions thereof. Also, time since loss was neither associated with personal growth nor positive reinterpretation, which differs from previous research (Drapeau et al., 2019; Engelkemeyer & Marwit, 2008; Yilmaz & Zara, 2016). However, the time since the loss of the spouse moderated the link between mindfulness and positive reinterpretation. Specifically, the longer the time since the spousal loss was the more positive the association between mindfulness and positive reinterpretation. This positive effect of mindfulness supports Kabat-Zinn’s (2005) notion that mindfulness enables transformation by generating greater capacity to hold and tolerate painful experiences. However, it remains unclear, why no such effect was found for personal growth. In line with López et al. (2015), we found that younger age was associated with higher personal growth. However, this was not true for positive reinterpretation. Likewise, higher education covaried with increased personal growth, but not with positive reinterpretation. This is in line with the inconsistent findings between adversarial growth and sociodemographic variables, including education (Linley & Joseph, 2004). Gender was neither associated with personal growth nor positive reinterpretation, which corroborates the mixed findings of previous studies (Onrust & Cuijpers, 2006; Stroebe, Stroebe, & Schut, 2001). Interestingly, widowed people did not differ from non-widowed people on the level of their personal growth and positive reinterpretation. This is in line with a study on people who experienced at least one life major event that also found no significant difference between widowed and non-widowed people on their posttraumatic growth (López et al., 2015).

To the best of our knowledge, this is the first study investigating the mechanism of spiritual mindfulness on perceived growth in widowed adults. Other strengths are the sample size of 250 widowed adults from a nationally representative U.S. sample and the inclusion of women and men across a broad age range. However, several limitations warrant further consideration. First, the current study does not provide information about the nature or context of loss. It may be that there are differences in perceived growth between individuals whose spouse’s death was violent or sudden (e.g., accident, suicide) versus those that lost their spouse at an expected life stage or as a result of a prolonged illness. For instance, Tedeschi and Calhoun (2006) hypothesized that unexpected deaths that are less consistent with the assumptive world views lead to greater distress and more growth. However, Caserta et al. (2009) found that stress-related growth was more likely for those who had expected their partners’ deaths. Further studies including the context of loss are needed. Second, the current study focused on widowed adults that were married once. The results may be different for widowed adults with a history of multiple marriages because they have already experienced a loss of a (once) loved person through divorce. In addition, reactions may differ among individuals who have experienced widowhood previously, relative to those who lost a spouse for the first time. Third, perceived growth was measured via self-reports and subsequently there is a possibility for response bias. That is, some individuals may report doing better than they actually are to convince themselves and possibly others that grief is being successfully managed (e.g., Frazier & Kaler, 2006).

Given the pervasiveness and centrality of widowhood in later life and the subsequent distress and risk for negative health outcomes, the current study addressed perceived growth after the loss of one’s spouse as a potential protective outcome. Since spiritual mindfulness seems to play an important role in predicting personal growth and positive reinterpretation after the death of one’s spouse, there is potential to develop and provide mindfulness trainings for widowed adults. In addition, high levels on spiritual mindfulness and private religious practices together tend to facilitate personal growth indicating that widowed adults should be encouraged to continue their private spiritual practices in a mindful way. With regard to positive reinterpretation, it seems that widowed adults need time after the loss, especially if they are not very mindful. Although these findings are promising, more research is needed about the mechanism of mindfulness along with religiosity in widowed adults.