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. Author manuscript; available in PMC: 2024 Mar 1.
Published in final edited form as: Anxiety Stress Coping. 2022 Feb 3;36(2):229–240. doi: 10.1080/10615806.2022.2033235

Spirituality, self-compassion, and anxiety among sexual minority men: A longitudinal meditation analysis

Jonathan Mathias Lassiter 1, Jared K O’Garro-Moore 2, Kainaat Anwar 1, Stacy W Smallwood 3, Inger E Burnett-Zeigler 4, Lara Stepleman 5, K Marie Sizemore 6, Christian Grov 7,8, H Jonathon Rendina 9,10
PMCID: PMC9346091  NIHMSID: NIHMS1776453  PMID: 35114866

Abstract

Background and Objective:

Research related to anxiety among sexual minority men (SMM) typically focuses on risk factors. It has seldom examined factors that may be associated with lower levels of anxiety. This gap in the literature represents an opportunity to explore positive psychological factors that may be related to lower levels of anxiety among this group. Spirituality and self-compassion are two positive psychological factors that have been associated with reduced anxiety in general samples but have been understudied among SMM. This study aimed to determine the longitudinal associations between spirituality, self-compassion, and anxiety.

Design and Methods:

Guided by an Afrocentric psychological framework, we conducted a secondary quantitative analysis with data from a racially and ethnically diverse sample of 697 U.S. SMM.

Results:

Utilizing Hayes PROCESS Macro Model 4, we found that spirituality at baseline was positively associated with self-compassion at baseline, which in turn was inversely associated with anxiety at 12-month follow-up.

Conclusions:

Overall, our findings provide evidence that spirituality and self-compassion are two positive psychological factors that are inversely associated with anxiety among SMM.

Keywords: Anxiety, spirituality, self-compassion, Black/Afrocentric psychology, gay men, mediation

Sexual minority (i.e., gay, bisexual, men who have sex with men [MSM], queer) men (SMM) experience disproportionate rates of anxiety-related mental health disorders. In fact, SMM have been found to have higher rates of panic disorder with and without agoraphobia, social anxiety, specific phobia, and generalized anxiety disorder compared to heterosexual men (Bostwick et al., 2010; Graham et al., 2011). Much of the research on anxiety among SMM has focused on risk factors (e.g., parental disapproval of self-expression, internalized homonegativity, incarceration; Choi et al., 2013; Graham et al., 2011; Pachankis & Bernstein, 2012). However, limited research has examined protective factors linked to anxiety among SMM. This oversight represents a gap in the literature related to SMM’s experience of anxiety and an opportunity to explore positive psychological factors that may be associated with less psychological distress among this group.

Literature Review

Spirituality and self-compassion may be two such positive psychological factors that can contribute to better mental health among SMM. We are careful to note that there are myriad psychological factors that may positively impact SMM’s mental health (e.g., sexual orientation acceptance and affirmation, connectedness with LGBTQ communities; Kaniuka et al., 2018; Schrimshaw et al., 2013). However, this article focuses on spirituality and self-compassion given our guiding theoretical framework (i.e., Optimal Conceptual Theory applied to sexual minorities [OCT-SM]; Lassiter & Mims, 2021) that emphasizes the importance of the sacred (i.e., spirit) to sexual minority people’s health. Spirituality – a multidimensional and transcendent personal relationship with the sacred – is a culturally-relevant factor among many SMM (Lassiter et al., 2020). Spirituality is a phenomenon mostly distinct from religion (Miller & Thoresen, 2003). Religion typically emphasizes a search for the sacred via religious texts, social issues, and institutional norms (Miller & Thoresen, 2003). Spirituality has been defined as a multidimensional and transcendent search for the sacred that is free from boundaries and, in some cases, has been found to be related to a union of the masculine and feminine energies and empowerment in the face of intersectional oppression (Halkitis et al., 2009; Lassiter et al., 2020). Spirituality, compared to religion, has consistently been found to be associated with predominately positive health outcomes for SMM (Lassiter et al., 2019; Poteat & Lassiter, 2019; Watkins et al., 2016). We acknowledge the harmful effects that homonegative and heterosexist interpretations of religious texts may have on SMM. We focus on spirituality in this article.

Among general samples (e.g., predominately white, presumed heterosexual, or socio-demographically undifferientated), spirituality has been associated with several positive mental health outcomes such as fewer depressive and anxiety symptoms (Brown et al., 2013), higher levels of honesty and responsibility which in turn were related to alcohol abstinence (Verghese, 2018), and lower rates of suicide (Koenig, 2009, 2010). While less research in this area has focused specifically on SMM, there is some evidence that these salubrious effects of spirituality on mental health exists for SMM. For example, Lassiter and colleagues (2019) found that higher levels of spirituality were associated with higher levels of social support and resilience and lower levels of depressive symptoms and rejection sensitivity among SMM. Similarly, Meanley and colleagues (2016) found that spiritual coping was associated with endorsing higher levels of self-esteem and feelings of purpose in life. These findings suggest that spirituality is an important factor to consider in SMM’s mental health.

Self-compassion may be another important positive psychological factor to consider in mental health research with SMM. Neff (2003a) defined self-compassion as the process of being kind to one’s self, understanding one’s existence as connected to others, and holding thoughts and emotions in balanced awareness. Studies with general samples have consistently reported robust findings indicating that greater self-compassion is associated with less anxiety (de Souza et al., 2020; Neff, 2003b). For example, higher scores on the Self-Compassion Scale (SCS) were consistently related to lower scores on various kinds of anxiety self-report scales (Neff, 2003b). Additionally, one meta-analysis conducted in 2017 with 21 randomized controlled trials (RCTs) using compassion-based interventions and a total of 1,285 participants concluded that compassion-based interventions helped cultivate both compassion and self-compassion, and reduced suffering (especially depression, anxiety, and other forms of psychological distress; Kirby et al., 2017).

Research with SMM also point to the benefits of self-compassion for mental health. For example, self-compassion has been found to be positively associated with general well-being (Beard et al., 2017) and negatively associated with symptoms of anxiety (Chan et al., 2020) among sexual minority people and SMM, respectively. Relatedly, Skinta and colleagues (2019) found that higher self-compassion was significantly inversely associated with anxiety symptoms. Furthermore, average and high levels of self-compassion (compared to lower levels) weakened the associations between HIV-related stigma, internalized homophobia, and negative affect, contributing to a nonsignificant relationship. Overall, extant research supports the inverse association between self-compassion and anxiety. Additionally, there is research that suggests that spirituality may facilitate self-compassion (Wasner et al., 2005; Benedict, 2014; Mokrzycka, 2017; Mathad et al., 2019). Thus, it may be possible for spirituality to influence anxiety by engendering self-compassion.

Unfortunately, there is no existing literature examining the association between spirituality and self-compassion among SMM, in particular. However, in other samples, research has indicated a significant link between the two phenomena. For example, one study evaluated the effects of a spiritual care program for palliative care professionals and found a significant increase in self-compassion up to 6 months after the program, indicating a connection between spirituality and self-compassion (Wasner et al., 2005). A study conducted among Turkish university students reported a significant positive correlation between spiritual experiences (i.e., connection with the transcendent in daily life) and self-compassion (Akin & Akin, 2017). Another study investigating the correlates and predictors of spiritual well-being (SWB) among nursing students found a positive correlation between SWB, mindfulness, satisfaction with life, and self-compassion. Furthermore, satisfaction with life, mindfulness, and self-compassion significantly explained 24% of the variance in participants’ SWB (Mathad et al., 2017). Although existing research supports the positive association between self-compassion and spirituality, this relationship has not been extensively studied or reported among SMM. Therefore, further research is needed to examine the potential of these two phenomena in determining positive health outcomes in this population. The current article aimed to address the gaps, highlighted above, in the spirituality, self-compassion, and anxiety research literature. This was undertaken with a culturally-grounded approach that started with the assumption that life has a spiritual nature, and that SMM’s consciousness of that spiritual nature influences their health.

Theoretical Framework

This article is framed by Optimal Conceptual Theory (OCT; Myers et al., 2018) applied to sexual and gender minority people (OCT-SGM; Lassiter & Mims, 2021). OCT-SGM builds on the work of Dr. Linda James Myers (1993) who articulated an optimal conceptual system grounded in the values of ancient pre-colonial African civilizations (e.g., Yoruba, Bantu-Congo) that center such qualities as spirituality, interconnectivity, and wholeness. OCT emphasizes that health is an outgrowth of spiritual consciousness whereby one understands themselves as connected to the life force (i.e., spirit) in all living things and having infinite potential. This spiritual consciousness fosters a worldview that is conducive to developing emotional, behavioral, and cognitive skills that are health-inducing (e.g., using self-talk that is affirming and highlights one’s agency in moments of distress instead of self-talk that is deprecating and induces feelings of powerlessness). A primary tenet of OCT is that spiritual and self-development are intertwined (Myers et al., 1991). As one cultivates spiritual consciousness, they become more receptive to viewing themselves and the world in a holistic, integrated manner that leads to self-discovery and self-acceptance (Myers et al., 1991). This holistic perspective of themselves and the world acknowledges the unique strengths and challenges of living life with multiple intersecting social identities (e.g., race, sexual orientation) that are marginalized by macrolevel systems of oppression (e.g., capitalism, White supremacy, heterosexism) and recognizes all life events – whether pleasant or painful – as opportunities for growth (Myers et al., 1991). While OCT has articulated an intersectional understanding of life, it has seldom focused its lens of analysis outside of issues of race and gender (Maat, 2010; Vance et al., 2021). OCT-SGM broadens the application of OCT to move beyond race and gender-based foci to explicitly include the concerns of SGM people who navigate heterosexism and cisgenderism in addition to other forms of oppression (e.g., poverty, ableism).

Building upon OCT, the primary assumptions of OCT-SGM are (a) life happens in a spiritual context and that human beings are the physical manifestation of spirit; (b) good health is achieved through perceptual, emotional, and behavioral alignment with the spiritual nature of life, (c) the relationships between the interlocking systems of oppression at the societal level interact with SGM people’s intersecting identities at the individual level to confer privilege (e.g., socioeconomic resources) and disadvantage (e.g., intersectional stressors) that vary across time and context, and (d) SGM people’s responses to varying levels of privilege and disadvantage and their spiritual alignment mutually influence each other. Lassiter and Mims (2021) found some empirical evidence supporting this conceptual framework. Myers (1993) has argued that OCT is both Afrocentric and universal given that it draws upon the customs and belief systems of pre-colonial African societies from which all humankind originated. Furthermore, OCT is “rooted in the historical realities of transcendence and resilience” (Myers et al., 2018, p.750). Thus, OCT-SGM may be a particularly appropriate culturally-grounded framework within which to understand how spirituality and self-compassion may influence mental health among racially diverse SMM who have demonstrated transcendence and resilience in various ways while navigating intersectional stressors.

Study Purpose and Hypotheses

The current study is a secondary data analysis aimed at assessing the longitudinal associations between spirituality, self-compassion, and anxiety among a sample of SMM in the United States (U.S.). Specifically, our research questions were:

  1. Is spirituality associated with anxiety over time?

  2. Does self-compassion mediate the relationship between spirituality and anxiety over time?

Based on the reviewed literature, our hypotheses were: (1) spirituality will be inversely associated with anxiety over time and (2) the influence of spirituality on anxiety will, at least partially, be explained by self-compassion. Findings from this article have the potential to add to the positive psychology literature related to SMM and inform clinical care for SMM who suffer from or may be at risk for anxiety-related mental health disorders.

Method

Participants and Procedures

This article reports on the findings of secondary data analysis with a subsample of 697 SMM from the One Thousand Strong Cohort, a longitudinal study that followed a U.S. national cohort of 1071 SMM for a period of 3 years. Our analyses for the present article are based on baseline and 12-month follow-up survey data that were collected using an at-home online survey. Specifically, we only included participants who reported experiencing at least “a little bit” of anxiety (a score of 1 or more on the anxiety measure; n = 697). This was done to ensure that our findings would be applicable to SMM who were experiencing anxiety and not be muddled by those participants who were not experiencing anxiety.

We summarize the recruitment and screening procedures for this study here, as they have been extensively described elsewhere (Grov et al., 2016). A marketing firm was used to draw panelists from over 200 sources that included LGBT events, social media, email broadcasts distributed by LGBTQ+ organizations, and nongay identified venues/mediums across the U.S. These panelists were contacted and screened for eligibility by research study staff. If panelists met eligibility criteria, they provided informed consent and were enrolled in the study.

Eligibility criteria included: (a) being a current resident in the U.S., (b) being at least 18 years of age, (c) being biologically male and identifying as male at the time of the study, (c) identifying as gay or bisexual, (d) reporting having had sex with a man in the past year, (e) self-identify as HIV-negative, (f) being willing to complete at-home self-administered rapid HIV antibody testing, and (g) being willing to complete self-administered sexually transmitted infection (STI) testing. In addition, participants had to be able to understand and comprehend the English language well enough to complete assessments which were in English, have Internet access, have access to a device that was capable of taking a digital photo, have an address to receive mail that was not a P.O. Box, and report residential stability (i.e., not having moved more than two times in the past six months). This study received ethical approval from The City University of New York (CUNY) Institutional Review Board.

The sample was comprised of primarily White SMM (73.5%). The South was the most endorsed geographic region of current residence. Most participants reported having obtained a 4-year college degree or higher level of education (56.0%). The most endorsed income category was $50,000 to $74,999 (16.9%). Most men identified as gay, queer, or homosexual (95.3%). The mean age of the sample was 39.1 (SD= 13.5).

Measures

Sociodemographic variables.

We used baseline assessments of participants’ self-reported age, income, educational level, race and ethnicity, sexual orientation, and geographic region (using the regions defined by the U.S. Census).

Anxiety.

Participants completed the Brief Symptoms Inventory 18 (BSI-18; Derogatis, 2001) at 12-month follow-up. We assessed participants’ level of anxiety with the BSI-18 anxiety subscale that consists of six items. These items instruct participants to rate their level of anxiety symptoms “over the last week” on a scale of 0 (not at all) to 4 (extremely). Sample anxiety symptoms included: “nervousness or shakiness inside,” “suddenly scared for no reason,” and “spells of terror or panic.” Items were summed and higher scores suggest higher levels of anxiety. Cronbach’s alpha for this sample was .85.

Spirituality.

We used baseline scores from The Ironson-Woods Sense of Peace subscale (Ironson et al., 2002) to assess spirituality. The Ironson-Woods Sense of Peace subscale consisted of nine items. Sample items include “My beliefs give me a sense of peace” and “My beliefs help me feel I have a relationship or a connection with a higher form of being.” Participants rated their agreement with the item on a scale of 1 (strongly disagree) to 6 (strongly agree). Items were summed and higher scores suggest higher levels of spirituality. Cronbach’s alpha for this sample was .94.

Self-compassion.

Baseline scores from the short form of the Self-Compassion Scale (Raes et al., 2011) were used to assess self-compassion. The measure consists of 12 items. Sample items include, “When I fail at something important to me I become consumed by feelings of inadequacy,” “I try to see my failings as part of the human condition,” and “When something upsets me I try to keep my emotions in balance.” Participants rated how often they behaved in the manners described by each item on a scale of 1 (almost never) to 5 (almost always). Items were summed and higher scores indicate higher levels of self-compassion. Cronbach’s alpha for our sample was .88.

Data Analyses

Initially, Pearson correlations were calculated to examine the associations among all study measures (BSI-18 Anxiety subscale, IW-Sense of Peace subscale, Self-Compassion Scale-Short Form), in order to investigate the concordance between anxiety, spirituality, and self-compassion. Next, Hayes’s (2012) PROCESS Macro (Preacher and Hayes, 2008) was used to test a simple mediation model. We tested the indirect effect of baseline levels of spirituality on prospective (12-month follow-up) anxiety symptoms, through self-compassion. For the mediation model, we used 10,000 bootstrap samples. The model was adjusted for education level based on previous research assessing the correlates of anxiety among SMM (Griffin et al., 2018).

Results

Descriptive statistics are displayed in Table 1. Bivariate associations among study variables are presented in Table 2.

Table 1.

Descriptive Statistics for Demographic and Study Variables

Variable N %
Age 39.1 13.6
Race
 Black 41 5.9
 Latinx 89 12.8
 White 512 73.5
 Other 55 7.9
Education
 Less than high school diploma 2 .3
 High school diploma or GED 48 6.9
 Some college 257 36.9
 4-year college degree or higher 390 56.0
Geographic Region
 South 243 34.9
 Northeast 142 20.4
 Midwest 118 16.9
 West 194 27.8
Income
 Less than $10,000 68 9.8
 $10,000 – $19,999 74 10.6
 $20,000 – $29,999 93 13.3
 $30,000 – $39,999 99 14.2
 $40,000 – $49,999 71 10.2
 $50,000 – $74,999 118 16.9
 $75,000 – $99,999 76 10.9
 $100,000 – $149,999 60 8.6
 $150,000 – $199,999 18 2.6
 $200,000 – $249,000 10 1.4
 $250,000 or more 10 1.4
Sexual Orientation
 Gay, queer, homosexual 664 95.3
 Bisexual 33 4.7
Mean Standard Deviation
Age 39.1 13.6
BSI-A 4.7 4.1
SCS-SF 38.3 9.1
IW-SOP 27.4 10.8
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Note. N = 697. BSI-A = Brief Symptoms Inventory-Anxiety subscale; SCS-SF = Self-compassion Scale-Short Form; IW-SOP = Ironson-Woods Sense of Peace subscale.

Table 2.

Pearson Correlations for Study Variables

Variable BSI-A IW-SOP SCS-SF
BSI-A 1 −.05 −.33**
IW-SOP 1 .30**
SCS-SF 1
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Note. BSI-A= Brief Symptom Inventory-Anxiety subscale, SCS-SF= Self-Compassion Scale-Short Form, IW-SOP= Ironson-Woods Sense of Peace subscale. N = 697.

*

denotes p < .05,

**

denotes p < .001.

Examination of the variables of interests (i.e., spirituality, self-compassion, and anxiety) demonstrated sufficiently normal distributions for the majority of the variables. However, a substantial positive skew (>1.0) existed for the BSI-A scores. To determine if the positive skew would substantially affect our results and thus warrant a data transformation, we conducted a sensitivity analysis whereby we ran our analyses with and without a logarithmic transformation. There was not a significant difference in patterns of statistical significance and therefore, we report the results of the analyses using the unmodified anxiety variable.

Model 4 of Hayes’s PROCESS Macro (2012) for SPSS was used to assess whether self-compassion mediated the association between spirituality and anxiety at 12-month follow-up. Spirituality was entered as the independent variable; education was entered as the covariate; and self-compassion was entered as a possible mediator. As Table 3 shows, results indicated that spirituality was positively associated with self-compassion (b = .25, t(694) = 8.24, p < .001). The direct association between spirituality and anxiety was nonsignificant (b = .02, t(693) = 1.33, p = .18). Self-compassion was negatively associated with anxiety (b = −.14, t(693) = −8.23, p < .001). The indirect effect of spirituality on anxiety through self-compassion was small but significant (b = −.04, SE = .01, 95% CI = −.05 –.02).

Table 3.

Bootstrapping Test of Mediation (Model 4) – IW-SOP Predicting to SCS-SF (Path a), SCS-SF Predicting BSI-A (Path b), and IW-SOP Predicting BSI-A Through SCS-SF (Path c’)

Predictor (X) Outcome (Y) Direct Effect of X on Y (SE) LLCI-UCLI for Direct Effect Indirect Effect of X on Y via SCS-SF (SE) LLCI-UCLI for Indirect Effect
IW-SOP SCS-SF .25** (.03) .19 – .31 — —
SCS-SF BSI-A −.14**(.02) −.17 – −.11 — —
IW-SOP BSI-A .02 (.01) −.01 – .05 −.04* (.01) −.05 – −.02
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Note. Controlled for education. BSI-A= Brief Symptom Inventory-Anxiety subscale, SCS-SF= Self-Compassion Scale-Short Form, IW-SOP= Ironson-Woods Sense of Peace subscale. SE = Standard error. LLCI= Lower Level Confidence Interval, ULCI= Upper Level Confidence Interval. N = 697.

*

denotes p < .05,

**

denotes p < .001.

Discussion

Summary of Findings

This study breaks new ground in its examination of the associations between spirituality, self-compassion, and anxiety among SMM. Our findings provide partial support for our hypotheses. Spirituality did not have a direct influence on anxiety across time for SMM in our sample. To our knowledge, no other studies conducted exclusively with SMM have assessed the direct association between spirituality and anxiety. Therefore, we cannot discuss this finding in the context of anxiety-specific research with SMM. More studies have assessed the direct association between spirituality and depressive symptoms among SMM and they have found both neutral and positive associations (Lassiter et al., 2019, Watkins et al., 2016). Our findings suggest that spirituality’s influence on SMM’s mental health may vary depending on specific mental health outcomes (e.g., anxiety vs depression). It may be that SMM’s personal relationship with the sacred is more helpful in navigating depressed and anhedonic emotions related to one’s self in the present moment compared to stopping worry about negative experiences in the future. For SMM, their negative experiences may be systemic (e.g., lack of protection from workplace discrimination due to sexual orientation) and thus worry about them may not be easily quelled with one’s beliefs and feelings of connection to the sacred alone.

Although we found no significant direct association between spirituality and anxiety, spirituality at baseline was significantly associated with self-compassion at baseline, which in turn was associated with anxiety at 12-month follow-up. Therefore, spirituality seems to have a long-term indirect association with anxiety over time via self-compassion. Stated another way, SMM’s feelings of meaning, comfort, strength, connection, and belief in the sacred may help them to treat themselves in ways that emphasize kindness, connection to a common humanity, and a balanced perspective about their experiences. These ways of treating one’s self may contribute to feeling less anxious in the future.

Clinical and Research Implications

The findings of this study suggest that spirituality and self-compassion are two positive psychological resources that are associated with lower levels of anxiety among SMM. Spirituality and self-compassion may help SMM navigate intersectional stressors such as heterosexism and other forms of oppression that could harm their mental health. Interpreted within the framework of OCT-SGM, SMM who cultivate a strong sense of meaning, comfort, strength, connection, and belief related to the sacred (i.e., optimal worldview) may find it easier to be more kind to themselves, focus on the present moment, and not isolate their struggles from those who are similar (i.e., proper consciousness and interconnectivity). Mental health clinicians who work with SMM may find benefit in helping them utilize their spiritual beliefs to find meaning and connection with something greater than themselves within their experiences of intersectional stressors. Clinicians may then leverage that sense of meaning and connection to engage in teaching SMM skills that promote self-compassion. Such skills would emphasize helping SMM treat themselves with care and self-soothe as well as viewing themselves as part of a common collective of marginalized people (currently and historically) which normalizes their pain and helps them find strength in symbolic and physical community. Mindfulness and emotional emancipation skills (Lassiter et al., 2020) are also tools that clinicians may employ to help their sexual minority male clients be present in unpleasant moments without trying to suppress or avoid pain, but instead allowing pain to teach them a lesson for positive psychological growth. Spirituality and self-compassion-focused mental health interventions with heterosexual people have been found to be effective (Barnard & Curry, 2011; Ferrari et al., 2019; Gonçalves et al., 2015) in reducing psychological distress and fostering other positive psychological outcomes (e.g., well-being, life satisfaction, and emotional intelligence). Our findings suggest that similar spirituality and self-compassion-focused mental health strategies may be beneficial for SMM.

This study raises more questions that could inform future research related to spirituality, self-compassion, and SMM’s mental health. Although OCT-SGM proposes that intersectional stressors may interfere with good health by hindering spiritual alignment, we did not directly include SMM’s experiences of intersectional stressors in our analyses. Instead, we interpreted our results in the context of distal intersectional stressors (e.g., living in a heterosexist and racist society). Future investigations may find it beneficial to include measures of proximal intersectional stressors (e.g., experiences of interpersonal homonegativity, race-related stress, psychosocial costs of racism) in their analyses related to spirituality, self-compassion, and SMM’s mental health. Including proximal intersectional stressors can help researchers assess whether these positive psychological factors may buffer SMM from negative mental health effects in the presence of those stressors. While spirituality proved to have a significant indirect association with anxiety through self-compassion, it only accounted for a small effect. This may be due to the specific aspects of spirituality that we measured in our study. We used the Sense of Peace subscale of the Ironson-Woods Spirituality/Religiousness Scale (2002) which assesses the extent to which one’s spiritual beliefs induce feelings of meaning, comfort, strength, connection, and belief in an afterlife. Analyses with other spirituality measures that examine different spiritual aspects such as spiritual well-being, spiritual needs, and spiritual support may find that they are more strongly associated with anxiety in SMM. Relatedly, we used the short form of the Self-Compassion Scale for which subscale interpretation is not recommended (Raes et al., 2011). Therefore, we were unable to investigate how separate dimensions of self-compassion (i.e., self-kindness, self-judgment, common humanity, isolation, mindfulness, over-identification) were related to spirituality and anxiety. Future studies may find it beneficial to use the 26-item version of the scale so that subscale analyses can be conducted. Refinement and elaboration of measurement could add nuanced detail to our understanding about how spirituality and self-compassion may influence SMM’s mental health.

Limitations

Although this study was designed in a way to maximize its contributions, it is not without limitations. We were unable to measure the study variables (i.e., spirituality, self-compassion, and anxiety) at three separate time-points. We measured spirituality and self-compassion at baseline and anxiety at 12-month follow-up. Therefore, we are unable to speak to spirituality’s ability to predict future feelings of self-compassion. Although we did find that higher levels of self-compassion were associated with lower levels of anxiety symptoms 12 months later, separate assessment points for each variable would have allowed us to draw more definitive conclusions about the longitudinal associations of both positive psychological factors with each other and anxiety. Thus, causality or temporality cannot truly be established from our findings. Including participants with a wide range of anxiety symptoms (e.g., low, moderate, high) may constitute a strength in our design in that it allows for the application of our findings to a large group of SMM. However, it may also constitute a limitation in that spirituality and self-compassion may be more influential among people with higher levels of psychological distress, and our inclusion of SMM with low and moderate anxiety symptoms may weaken our ability to detect that influence. The small number of SMM of color in sample left us underpowered to determine differences among these groups related to the study variables. Additionally, our hypotheses were not pre-registered which some scholars have suggested could reduce publication bias and ensure that research teams share a clear understanding of their research goals and processes (Alvarez, 2014; American Psychological Association, 2021). However, the nature of secondary data analysis precludes hypotheses from being pre-registered.

Conclusions

Our study provides evidence that spirituality and self-compassion are two positive psychological factors that are inversely associated with anxiety among SMM. Despite living in a world in which they often must confront intersectional stressors due to pervasive systemic oppression, SMM are able to cultivate relationships with the sacred and themselves that facilitate a disposition of self-kindness, community with humankind, and a nonjudgmental experience of the present moment. These qualities are consistent with an Afrocentric worldview that emphasizes spiritual alignment with the sacred. Our study provides evidence that such spiritual alignment bodes well for SMM’s mental health.

Acknowledgements:

The One Thousand Strong study was funded by a research grant from the National Institute on Drug Abuse (R01-DA036466, MPIs: Christian Grov, H. Jonathon Rendina, & Jeffrey T. Parsons). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would like to acknowledge the contributions of other members of the One Thousand Strong Study Team (Jeffrey Parsons, Mark Pawson, Ruben Jimenez, Kendell Doyle, Brian Salfas, Brett Millar, Raymond Moody, and Thomas Whitfield) as well as Dr. Jeffrey Schulden at NIDA and all of our study participants who volunteered their time.

Footnotes

Disclosure of Interest: The authors report no conflicts of interest.

Data Deposition: This data has not been deposited in a data repository.

Data Availability Statement:

The data used in this analysis may be requested by contacting the senior author of this manuscript: H. Jonathon Rendina at JRendina@whitman-walker.org

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data used in this analysis may be requested by contacting the senior author of this manuscript: H. Jonathon Rendina at JRendina@whitman-walker.org

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