Original Paper for Japanese Health Psychology
Title: A model of Spirituality Contribute to Health--Through a Development of the Scale
Abstract:
The objectives of this study were (1) to develop a valid and reliable assessment tool of spirituality that would be useful in the field of health psychology, and (2) to investigate a conceptual model of an individual’s mature spirituality as a personality trait which should be related to the holistic health. After a conceptual survey of spirituality, an original scale of spirituality (Psychosynthesis Questionnaire) was made based on the outcome of the survey and psychosynthesis theory. A multi-site, cross-sectional survey was conducted using university students in a large metropolitan area (N = 1396) with this scale. The exploratory factor analysis identified three factors: spiritual behavior, spiritual attitude and spiritual sensitivity. These 3 factors were also named Will, Joy and Sense. A short version of a measurement tool for the spirituality, the SBAS (Spiritual Behavior, Attitude, Sensitivity) - Test was developed based on the result of the exploratory factor analysis . The instrument reliability of SBAS-TEST was confirmed (Cronbach’s α=0.82, test-retest corelasions ,r=0.82). SBAS-TEST also shows the sufficient concurrent validity , significant correlations with SOC, (r = 0.47, P <0.01). The correlations between Will, Joy and SOC were r = 0.49 (P <0.01), r = 0.57, (P <0.01) respectedly. There was no significant correlations between spiritual sensitivity and SOC. Theses results suggest that the SBAS -Test is a valid and reliable assessment tool that can be used in the field of health psychology. Will and Joy which showed high correlation with SOC are able to be identified as the factors directly related to health; however spiritual sensitivity itself (transcendental aspect) may not be considered to contribute to health.
Keywords: Spirituality, Sense of Coherence, Will, Joy, Transcendent
1. Introduction: What is Spirituality?
The term Spirituality reminds us of something mysterious and anti-scientific. In Japanese, Spirituality is translated as “reisei” which carries more of an occult image and sounds dangerous to the ordinary people despite its original concept addressed by Taisetsu Suziki(Suzuki,1968). The definition of Spirituality varies by the context (Wilber,2000).
Spirituality is not the concept limited to religion or something mysterious which have become popular among the general public to search for the meaning and the purpose of life. The dangerous aspects of such easy going spiritual trainings are known to cause a serious psychological damage to immature or unhealthy individuals(Grof,1989; Ozaki and Suzuki,2005). The importance of distinguishing the healthy spirituality and unhealthy, dangerous spirituality has been addressed(Kogo,2002), However, giving an educational advice to differentiate between healthy and unhealthy forms of spirituality is a sensitive issue and causes the psychological resistance even to talk about the spirituality because it includes an individual’s religious belief, and values.
The concept of spiritual health was proposed in 1998 while working toward a new definition of health within the World Health Organization (WHO,1998), however no consensus has been reached yet. In part, that is also because of the anti-scientific image of spirituality.
In the US Department of Health and Human Services, holistic education has been widely recognized with the new spiritual movement (Miller,2001). Holistic education is carefully separated from religious education and focuses on existential issues to look for the purpose and the meaning of life. The Department emphasizes that these issues are highly related to mental health and that the recognition of the transpersonal existence is essential for well-being.
In transpersonal psychology, Spirituality is defined as non-local consciousness. It means beyond our descriptive world and most of them think it is nonsense to try to measure spirituality saying that spirituality is something unexplainable and immeasurable (Ozaki,2005a).. However, in the field of positive psychology spirituality is explained as a highly developed personality trait such as faith, hope, love, joy, forgiveness, and care for others (Valliant,2004).
The concept of spirituality in this study is based on psychosynthesis theory. Psychosynthesis means mental integration, and it is called ‘a Psychology which has love, soul and will’. Psychosynthesis was proposed by the Italian psychiatrist Assagioli in 1910 and it has been developed as an important theory and practice for transpersonal psychology.
Psychosynthesis theory focuses on super consciousness or upper unconsciousness in addition to the unconsciousness which Freud proposed. The purpose of Psychosynthesis is to recover the relationship between personal self and transpersonal self, which is described as the truth, love, life, eternity, original value etc.. The act of will plays an important role to integrate these two self to make whole personality. According to Assagioli the true function of the will is not to repress the personal drives (id) to achieve the accomplishment of the individual’s purpose. The will has a directive and regulatory function; it balances and constructively utilizes all the other activities and energies of the human being without repressing any of them (Assagioli,1974).
Psychosynthesis emphasizes the training of will power which needs conscious effort and related cognitive domain rather than emotional domain .This may be different from the general impression of Psychosynthesis which is famous for its image training focusing on sense more than intellectual or logical thinking. Therefore Psychosynthesis is considered to be a balanced approach to use both acts of will and joy, which comes from the integration of the personal self and the transpersonal self.
The efforts to develop an instrument to measure spirituality have made mainly in the fields of nursing, socio-medicine, and hospice care fields (Ellison, 1983; Daaleman and Frey, 2004 ;Direnedonck ,2004 ;Atkinson et al.; 2004; Ledbetter et al., 1991; Holland et al.,1998). In this study, I have developed an assessment tool to measure the individual maturity level of spirituality as a personality trait ,which should be the main element of holistic health or well-being.
2.Objectives
The objectives of this study were (1) to develop a valid and reliable assessment tool of spirituality that would be useful in health psychology, and (2) to investigate a conceptual model of an individual’s mature spirituality as a personality trait which should be related to holistic health, or well-being.
3. Methods
3. 1 Conceptual survey
Seventy persons (m=60, f=10) were selected from among the board members of the Japan Transpersonal Association. A descriptive questionnaire about spirituality was sent by E-mail to them and they were asked to E-mail back their answers. Replies were received from 24 (m＝18, f＝4) for a 34.3% participation rate (July to September, 2004).
The participants were asked to answer the following question within 20 to 600 words.
“What kind of objective scales would be possible to measure an individual's maturity level of Spirituality?”
The publication of the results as a research paper with the participant’s name and original answer were announced at inquiry of the survey.
3. 2 Development of the questionnaire
College students (1397; m= 635, f= 762, Age 19.35±0.86 years old) in the Tokyo metropolitan area from 8 different private colleges replied to the questionnaire during their regular classes.
The Psychosynthesis Questionnaire (the 63-items, consisted of 9 Domain, Act of will, Self-esteem, Relatedness, Joy, Prepersonal spirituality, Existential spirituality, Openness, Morality, and Lie scale)(Ozaki,2005) was administered during regular classes. Demographic information (subject’s age, sex, major, and year of university) was also collected.
3. 3 Data analysis
Data from the conceptual survey were categorized by the KJ method.
All items of the Psychosynthesis Questionnaire were coded and scored, and the answers that were partially completed were excluded from analysis. Descriptive and inferential analyses were performed using SPSS. An exploratory factor analysis examined the unknown factors on the Psychosynthesis Questionnaire.
According to the three factors raised through the exploratory factor analysis a new short version of the Spirituality scale, SBAS-(Spiritual Behavior, Attitude, and Sensitivity) Test was made. Reliability was calculated by internal consistency and test-retest coefficients using data of 108 students collected two weeks after the first questionnaire was asked. To determine convergent and divergent validity of SBAS-TEST, a relationship matrix of correlations among subscales was examined. For the criterion validity or concurrent validity the correlation between SBAS-TEST and SOC (Scale of Sense of Coherence) were calculated.
4. Results
4.1 Survey of the concept
The responses were divided into five categories.
1. No comment.
2. Nonsense to measure spirituality.
3. With an operational definition, measurement of spirituality would be possible within limitations.
4. As personal experience or awareness of the transpersonal domain, spirituality would be measured.
5. By measuring psychological maturity level, Spirituality would be measured.
In the fifth category, peace，warmth，balance，love, humor, and originality were explained as psychological maturity level.
4. 2 Exploratory factor analysis
Exploratory factor analysis with Plomax Rotation was used to identify the concepts measured by the Psychosynthesis Questionnaire. These results were compared with the original nine domains. An initial solution resulted in five factors being identified with the scree plot test, however two of those factors contained only a few weakly loaded items. A solution of three factors was the cleanest, with items having loadings greater than 0.40. Items with weaker or split loadings across factors were removed(Table 1.).
Factor 1 contained 8 items from the original act of will domain and 1 item from self esteem domain. Factor 1 was named ‘spiritual behavior’ or ‘will ‘which is decision-making and to conduct to select a positive direction toward the well being of the individual, of the others and also of the whole universe. Factor 2 was composed of 6 items in total: 3 items assessing ‘Joy ‘in Psychosynthesis Questionnaire, 3 from the relatedness domain, 2 from self esteem domain, and 1 from act of will domain. This factor was named ‘spiritual attitude’, or ‘Joy ‘which is a Joyful and thankful attitude spontaneously emerged from within independently from outside events.
Factor 3 was constructed by 10 items in total: 6 items were obtained from the existential spirituality domain, 3 from the pre-personal domain and 1 item from joy of the original questionnaire. This factor was named ‘spiritual sensitivity’ ,or ‘sense’ which is the sensitivity to be aware for the super-sensory dimension of the consciousness such as peak experiences.(Fig. 1.)
4. 3 Reliability and validity of SBAS-TEST
The SBAS-TEST produced a coefficient α of 0.82, indicating good internal consistency. The domains of Will, Joy, and Sense also showed good reliability as indicated (Table 1.). 108 of the 1396 respondents completed the SBAS-TEST for the second time two weeks after the initial administration．The test-retest correlation for the total SBAS-TEST was 0.82 and among domains a high correlation were also found for Will (r=0.86, p>0.01), Joy (r=0.79, p>0.01) and Sense (r=0.78, p>0.01).
To determine convergent and divergent validity of the SBAS-TEST, a relationship matrix of correlations among domains was made as shown in Table 2. Among the 3 domains spiritual behavior (Will) and spiritual attitude (Joy) has a significant correlation (r=0.53, p>0.01), however spiritual sensitivity (Sense) shows no significant correlations with spiritual behavior nor spiritual attitude. SOC has high correlations with the total score of SBAS-TEST, (r=0.47,p>0.01) spiritual behavior (r=0.49,p>0.01) ,spiritual attitude (r=0.57,p>0.01) ,but not with spiritual sensitivity (r=0.04, ns).
5. Discussion
Will and Joy domains of SBAS-TEST have high correlations with the scale of Sense of Coherence. There have been reported the strong stable correlation between SOC and mental health(Antonosky and Sagy,1986;Frenz et al.,1993; Gritz et al.,1991; Zika and Chamberlain,1992), optimism（Sack et al.,1997）, Quality of Life (QOL) (Dahlin et al.,1990). According to these facts, will and Joy domains would be determined to be health related aspects of spirituality, and are represented as the ideal, mature personality traits. With this the type of the spirituality was proposed in Figs. 3 .
However without noticing the transpersonal dimension, will and joy can be immature, selfish personality trait according to the individual’s cognitive and moral phase. To achieve the authentic spirituality, the balanced development of all three domains is indispensable.
Eight types of the spirituality are explained by these three domains of Spirituality (Table 3,Fig.3).When we distinguish the individual’s spirituality according to the three domains the suitable psychological approaches for each type can be proposed. To strengthen spiritual behavior; we can use cognitive behavioral therapy and life skill program. For spiritual attitude, Existential approach such as logo therapy would be appropriate. To nourish spiritual sensitivity, Transsendential Meditation ,Image training from psychosynthesis should be effective.
Describing Spirituality is a sensitive issue and the possible misunderstanding of the explanation of the items among participants cannot be denied. To generalize the outcome of this study, an international or intercultural survey is awaited.
６. Conclusion
The SBAS -Test is a valid and reliable assessment tool that can be used in health psychology. Will and Joy which showed high correlation with SOC were able to be identified as the health related domains of Spirituality; however Sensitivity itself (transcendental aspect) may not be considered to be on the health side of Spirituality. For the holistic development of the authentic spirituality , all three domains should be grown in balance.
Fig. 1. Relation of the original domains and 3 factors.
Fig. 2. Conceptual relatedness between three factors and the SOC.
Table 1. Factor structure of SBAS-TEST
ST SB SA SS
ST
SB 0.71**
SA 0.66** 0.53**
SS 0.62** 0.18 0.07
ST=Total score of SBAS-TEST,
SB=Spiritual Behavior (Will),
SA=Spiritual Attitude (Joy),
SS=Spiritual Sensitivity (Sense)
Note: **Correlations significant at <0.001 (2-tailed)
Table 4. Correlations between scales and domains of SBAS-TEST and SOC.
ST=Total score of SBAS-TEST,
SB=Spiritual Behavior (Will),
SA=Spiritual Attitude (Joy),
SS=Spiritual Sensitivity (Sense)
SOC=Sense of Coherence,
ME=Meaningfulness, CO=Comprehensibility,
MA=Manageability,
Note: *Correlations significant at <0.001 (2-tailed)
References
1) Wilber K.: Integral Psychology - Consciousness, Spirit, Psychology, Therapy, Shambhala, Boston, 2000.
2) Ozaki M. and Suzuki N.: Contemporary Viewpoints of Japanese Transpersonalists, Japanese Journal of Transpersonal Studies, 7: 75-92, 2005.
3) Valliant G.:
http://
4) Ellison C.W.: Spiritual Well-Being: Conceptualization and Measurement, J Psychol. Theol. 11: 330-340, 1983.
5) Daaleman T.P. and Frey B.B.: The Spirituality Index of Well-Being: A New Instrument for Health -Related Quality-of-Life Research. Annals of Family Medicine, 2: 499-503, 2004.
6) Dierendonck D.: The Construct Validity of Ryff’s Scales of Psychological Well-being and Its Extension with Spiritual Well-Being, Personality and Individual Differences, 36(3): 629-643, 2004.
7) Atkinson M.J., Wishart P.M., Wasil B.I., Robinson J.W.: The Self-Perception and Relationships Tool (S-PRT): A Novel Approach to the Measurement of Subjective Health-Related Quality of Life, Health and Quality of Life Outcomes, 2: 2004.
8) Ledbetter M.F., Smith L.A., Vosler-Hunter W.L., Fischer J.D.: An Evaluation of the Research and Clinical Usefulness of the Spiritual Well-Being Scale, J. Psychol. Theol., 19: 49-55, 1991.
9) Holland J.C., Kash K.M., Passick S., et al.: A Brief Spiritual Beliefs Inventory for Use in Quality-of-Life Research in Life-Threatening Illness, Psycho-oncology, 7: 460-469, 1998.
10) Ozaki M.: Healthy Spirituality, Japanese Journal of Transpersonal Studies, 7. 25-35 2005.
11) Grof S. and Grof C.: Spiritual Emergency, Penguin Putnam, 1989.
12) Assagioli R.: The Act of Will. The Psychosynthesis and Education Trust, London, 1974.
13) Wilber K.: Sex, Ecology, Spirituality: The Spirit of Evolution, Shambhala, Boston, 1995.
14) Kogo Y.: Aum Shinrikyo and Spiritual Emergency. Journal of Humanistic Psychology, 42: 82-101, 2002.
15) Suzuki T.: Japanese Spirituality, Iwanami, Tokyo, 1968.
16) World Health Organization: Executive Board 101st Session, Review of the Constitution of the World Health Organization: Report in executive board special group. EB101.R2/Agenda item 7.3, 1998.
17) Miller J.: Education and The Sole: State University of New York Press, Albany, 2001.
18) Doolittle B.R., Farrell M.: Prime Care Companion the Association Between Spirituality and Depression in an Urban Clinic, J. Clin. Psychiatry., 6(3): 114-118, 2004.
19) Assagioli R: Psychosynthesis, Psychosynthesis Research Foundation, New York,1965.
20) Okano M: Psychology for self-confidence-Introduction of Cosmology Therapy, PHP Publishing, Tokyo, 2002.
21) Ishikawa Y: Meaning and Challenge of Cosmology Education, Sanguraga, NL44-54, 2004.
22) Schuffel,Brucks,Johnen et al.: Handbuch der Salutogenese: Konzept und Praxis, Ullstein Medical Verlagsgesellschft mbH and Co.,Wiesbaden,1998
23)
9) Antnovsky H. and Sagy S.: The Development of a Sense of Coherence and Its Impact on Responses to Stress Situations. J. Soc. Psychology, 126: S213-225, 1986.
10) Frenz A. W., Carey M. P. and Jorgensen R. S.: Psychometric Evaluation of Antonovsky’s Sense of Coherence Scale, Psychological Assessment, 5: S145-153, 1993.
11) Gritz E. R., Wellisch D. K., Siau J. and Wang H. J.: Long Term Effects of Testicular Cancer on Material Relationships, Psychosomatics, 31: S301-312, 1990.
12) Zika S. and Chamberlain K.: On the Relation between Meaning in Life and Psychological Well−Being, British J. Psychol., 83: S133-145, 1992.
13) Sack M., Kunsebeck H. -W. and Lamprecht F.: Koharenzgefuhl und Psychosomatischer Behandlungserfolg-eine Empirische Untersuchung zur Salutogenese. Psychother. Psychosom. Med. Psychol., 47: S149-155, 1997.
14) Dahlin L., Cederblad M., Antonovsky A. and Hagnell O.: Childhood Vulnerability and Adult Invincibility, Acta Psychiatr. Scand., 82: S228-232, 1990.
Title: A model of Spirituality Contribute to Health--Through a Development of the Scale
Abstract:
The objectives of this study were (1) to develop a valid and reliable assessment tool of spirituality that would be useful in the field of health psychology, and (2) to investigate a conceptual model of an individual’s mature spirituality as a personality trait which should be related to the holistic health. After a conceptual survey of spirituality, an original scale of spirituality (Psychosynthesis Questionnaire) was made based on the outcome of the survey and psychosynthesis theory. A multi-site, cross-sectional survey was conducted using university students in a large metropolitan area (N = 1396) with this scale. The exploratory factor analysis identified three factors: spiritual behavior, spiritual attitude and spiritual sensitivity. These 3 factors were also named Will, Joy and Sense. A short version of a measurement tool for the spirituality, the SBAS (Spiritual Behavior, Attitude, Sensitivity) - Test was developed based on the result of the exploratory factor analysis . The instrument reliability of SBAS-TEST was confirmed (Cronbach’s α=0.82, test-retest corelasions ,r=0.82). SBAS-TEST also shows the sufficient concurrent validity , significant correlations with SOC, (r = 0.47, P <0.01). The correlations between Will, Joy and SOC were r = 0.49 (P <0.01), r = 0.57, (P <0.01) respectedly. There was no significant correlations between spiritual sensitivity and SOC. Theses results suggest that the SBAS -Test is a valid and reliable assessment tool that can be used in the field of health psychology. Will and Joy which showed high correlation with SOC are able to be identified as the factors directly related to health; however spiritual sensitivity itself (transcendental aspect) may not be considered to contribute to health.
Keywords: Spirituality, Sense of Coherence, Will, Joy, Transcendent
1. Introduction: What is Spirituality?
The term Spirituality reminds us of something mysterious and anti-scientific. In Japanese, Spirituality is translated as “reisei” which carries more of an occult image and sounds dangerous to the ordinary people despite its original concept addressed by Taisetsu Suziki(Suzuki,1968). The definition of Spirituality varies by the context (Wilber,2000).
Spirituality is not the concept limited to religion or something mysterious which have become popular among the general public to search for the meaning and the purpose of life. The dangerous aspects of such easy going spiritual trainings are known to cause a serious psychological damage to immature or unhealthy individuals(Grof,1989; Ozaki and Suzuki,2005). The importance of distinguishing the healthy spirituality and unhealthy, dangerous spirituality has been addressed(Kogo,2002), However, giving an educational advice to differentiate between healthy and unhealthy forms of spirituality is a sensitive issue and causes the psychological resistance even to talk about the spirituality because it includes an individual’s religious belief, and values.
The concept of spiritual health was proposed in 1998 while working toward a new definition of health within the World Health Organization (WHO,1998), however no consensus has been reached yet. In part, that is also because of the anti-scientific image of spirituality.
In the US Department of Health and Human Services, holistic education has been widely recognized with the new spiritual movement (Miller,2001). Holistic education is carefully separated from religious education and focuses on existential issues to look for the purpose and the meaning of life. The Department emphasizes that these issues are highly related to mental health and that the recognition of the transpersonal existence is essential for well-being.
In transpersonal psychology, Spirituality is defined as non-local consciousness. It means beyond our descriptive world and most of them think it is nonsense to try to measure spirituality saying that spirituality is something unexplainable and immeasurable (Ozaki,2005a).. However, in the field of positive psychology spirituality is explained as a highly developed personality trait such as faith, hope, love, joy, forgiveness, and care for others (Valliant,2004).
The concept of spirituality in this study is based on psychosynthesis theory. Psychosynthesis means mental integration, and it is called ‘a Psychology which has love, soul and will’. Psychosynthesis was proposed by the Italian psychiatrist Assagioli in 1910 and it has been developed as an important theory and practice for transpersonal psychology.
Psychosynthesis theory focuses on super consciousness or upper unconsciousness in addition to the unconsciousness which Freud proposed. The purpose of Psychosynthesis is to recover the relationship between personal self and transpersonal self, which is described as the truth, love, life, eternity, original value etc.. The act of will plays an important role to integrate these two self to make whole personality. According to Assagioli the true function of the will is not to repress the personal drives (id) to achieve the accomplishment of the individual’s purpose. The will has a directive and regulatory function; it balances and constructively utilizes all the other activities and energies of the human being without repressing any of them (Assagioli,1974).
Psychosynthesis emphasizes the training of will power which needs conscious effort and related cognitive domain rather than emotional domain .This may be different from the general impression of Psychosynthesis which is famous for its image training focusing on sense more than intellectual or logical thinking. Therefore Psychosynthesis is considered to be a balanced approach to use both acts of will and joy, which comes from the integration of the personal self and the transpersonal self.
The efforts to develop an instrument to measure spirituality have made mainly in the fields of nursing, socio-medicine, and hospice care fields (Ellison, 1983; Daaleman and Frey, 2004 ;Direnedonck ,2004 ;Atkinson et al.; 2004; Ledbetter et al., 1991; Holland et al.,1998). In this study, I have developed an assessment tool to measure the individual maturity level of spirituality as a personality trait ,which should be the main element of holistic health or well-being.
2.Objectives
The objectives of this study were (1) to develop a valid and reliable assessment tool of spirituality that would be useful in health psychology, and (2) to investigate a conceptual model of an individual’s mature spirituality as a personality trait which should be related to holistic health, or well-being.
3. Methods
3. 1 Conceptual survey
Seventy persons (m=60, f=10) were selected from among the board members of the Japan Transpersonal Association. A descriptive questionnaire about spirituality was sent by E-mail to them and they were asked to E-mail back their answers. Replies were received from 24 (m＝18, f＝4) for a 34.3% participation rate (July to September, 2004).
The participants were asked to answer the following question within 20 to 600 words.
“What kind of objective scales would be possible to measure an individual's maturity level of Spirituality?”
The publication of the results as a research paper with the participant’s name and original answer were announced at inquiry of the survey.
3. 2 Development of the questionnaire
College students (1397; m= 635, f= 762, Age 19.35±0.86 years old) in the Tokyo metropolitan area from 8 different private colleges replied to the questionnaire during their regular classes.
The Psychosynthesis Questionnaire (the 63-items, consisted of 9 Domain, Act of will, Self-esteem, Relatedness, Joy, Prepersonal spirituality, Existential spirituality, Openness, Morality, and Lie scale)(Ozaki,2005) was administered during regular classes. Demographic information (subject’s age, sex, major, and year of university) was also collected.
3. 3 Data analysis
Data from the conceptual survey were categorized by the KJ method.
All items of the Psychosynthesis Questionnaire were coded and scored, and the answers that were partially completed were excluded from analysis. Descriptive and inferential analyses were performed using SPSS. An exploratory factor analysis examined the unknown factors on the Psychosynthesis Questionnaire.
According to the three factors raised through the exploratory factor analysis a new short version of the Spirituality scale, SBAS-(Spiritual Behavior, Attitude, and Sensitivity) Test was made. Reliability was calculated by internal consistency and test-retest coefficients using data of 108 students collected two weeks after the first questionnaire was asked. To determine convergent and divergent validity of SBAS-TEST, a relationship matrix of correlations among subscales was examined. For the criterion validity or concurrent validity the correlation between SBAS-TEST and SOC (Scale of Sense of Coherence) were calculated.
4. Results
4.1 Survey of the concept
The responses were divided into five categories.
1. No comment.
2. Nonsense to measure spirituality.
3. With an operational definition, measurement of spirituality would be possible within limitations.
4. As personal experience or awareness of the transpersonal domain, spirituality would be measured.
5. By measuring psychological maturity level, Spirituality would be measured.
In the fifth category, peace，warmth，balance，love, humor, and originality were explained as psychological maturity level.
4. 2 Exploratory factor analysis
Exploratory factor analysis with Plomax Rotation was used to identify the concepts measured by the Psychosynthesis Questionnaire. These results were compared with the original nine domains. An initial solution resulted in five factors being identified with the scree plot test, however two of those factors contained only a few weakly loaded items. A solution of three factors was the cleanest, with items having loadings greater than 0.40. Items with weaker or split loadings across factors were removed(Table 1.).
Factor 1 contained 8 items from the original act of will domain and 1 item from self esteem domain. Factor 1 was named ‘spiritual behavior’ or ‘will ‘which is decision-making and to conduct to select a positive direction toward the well being of the individual, of the others and also of the whole universe. Factor 2 was composed of 6 items in total: 3 items assessing ‘Joy ‘in Psychosynthesis Questionnaire, 3 from the relatedness domain, 2 from self esteem domain, and 1 from act of will domain. This factor was named ‘spiritual attitude’, or ‘Joy ‘which is a Joyful and thankful attitude spontaneously emerged from within independently from outside events.
Factor 3 was constructed by 10 items in total: 6 items were obtained from the existential spirituality domain, 3 from the pre-personal domain and 1 item from joy of the original questionnaire. This factor was named ‘spiritual sensitivity’ ,or ‘sense’ which is the sensitivity to be aware for the super-sensory dimension of the consciousness such as peak experiences.(Fig. 1.)
4. 3 Reliability and validity of SBAS-TEST
The SBAS-TEST produced a coefficient α of 0.82, indicating good internal consistency. The domains of Will, Joy, and Sense also showed good reliability as indicated (Table 1.). 108 of the 1396 respondents completed the SBAS-TEST for the second time two weeks after the initial administration．The test-retest correlation for the total SBAS-TEST was 0.82 and among domains a high correlation were also found for Will (r=0.86, p>0.01), Joy (r=0.79, p>0.01) and Sense (r=0.78, p>0.01).
To determine convergent and divergent validity of the SBAS-TEST, a relationship matrix of correlations among domains was made as shown in Table 2. Among the 3 domains spiritual behavior (Will) and spiritual attitude (Joy) has a significant correlation (r=0.53, p>0.01), however spiritual sensitivity (Sense) shows no significant correlations with spiritual behavior nor spiritual attitude. SOC has high correlations with the total score of SBAS-TEST, (r=0.47,p>0.01) spiritual behavior (r=0.49,p>0.01) ,spiritual attitude (r=0.57,p>0.01) ,but not with spiritual sensitivity (r=0.04, ns).
5. Discussion
Will and Joy domains of SBAS-TEST have high correlations with the scale of Sense of Coherence. There have been reported the strong stable correlation between SOC and mental health(Antonosky and Sagy,1986;Frenz et al.,1993; Gritz et al.,1991; Zika and Chamberlain,1992), optimism（Sack et al.,1997）, Quality of Life (QOL) (Dahlin et al.,1990). According to these facts, will and Joy domains would be determined to be health related aspects of spirituality, and are represented as the ideal, mature personality traits. With this the type of the spirituality was proposed in Figs. 3 .
However without noticing the transpersonal dimension, will and joy can be immature, selfish personality trait according to the individual’s cognitive and moral phase. To achieve the authentic spirituality, the balanced development of all three domains is indispensable.
Eight types of the spirituality are explained by these three domains of Spirituality (Table 3,Fig.3).When we distinguish the individual’s spirituality according to the three domains the suitable psychological approaches for each type can be proposed. To strengthen spiritual behavior; we can use cognitive behavioral therapy and life skill program. For spiritual attitude, Existential approach such as logo therapy would be appropriate. To nourish spiritual sensitivity, Transsendential Meditation ,Image training from psychosynthesis should be effective.
Describing Spirituality is a sensitive issue and the possible misunderstanding of the explanation of the items among participants cannot be denied. To generalize the outcome of this study, an international or intercultural survey is awaited.
６. Conclusion
The SBAS -Test is a valid and reliable assessment tool that can be used in health psychology. Will and Joy which showed high correlation with SOC were able to be identified as the health related domains of Spirituality; however Sensitivity itself (transcendental aspect) may not be considered to be on the health side of Spirituality. For the holistic development of the authentic spirituality , all three domains should be grown in balance.
Fig. 1. Relation of the original domains and 3 factors.
Fig. 2. Conceptual relatedness between three factors and the SOC.
Table 1. Factor structure of SBAS-TEST
ST SB SA SS
ST
SB 0.71**
SA 0.66** 0.53**
SS 0.62** 0.18 0.07
ST=Total score of SBAS-TEST,
SB=Spiritual Behavior (Will),
SA=Spiritual Attitude (Joy),
SS=Spiritual Sensitivity (Sense)
Note: **Correlations significant at <0.001 (2-tailed)
Table 4. Correlations between scales and domains of SBAS-TEST and SOC.
ST=Total score of SBAS-TEST,
SB=Spiritual Behavior (Will),
SA=Spiritual Attitude (Joy),
SS=Spiritual Sensitivity (Sense)
SOC=Sense of Coherence,
ME=Meaningfulness, CO=Comprehensibility,
MA=Manageability,
Note: *Correlations significant at <0.001 (2-tailed)
References
1) Wilber K.: Integral Psychology - Consciousness, Spirit, Psychology, Therapy, Shambhala, Boston, 2000.
2) Ozaki M. and Suzuki N.: Contemporary Viewpoints of Japanese Transpersonalists, Japanese Journal of Transpersonal Studies, 7: 75-92, 2005.
3) Valliant G.:
http://
4) Ellison C.W.: Spiritual Well-Being: Conceptualization and Measurement, J Psychol. Theol. 11: 330-340, 1983.
5) Daaleman T.P. and Frey B.B.: The Spirituality Index of Well-Being: A New Instrument for Health -Related Quality-of-Life Research. Annals of Family Medicine, 2: 499-503, 2004.
6) Dierendonck D.: The Construct Validity of Ryff’s Scales of Psychological Well-being and Its Extension with Spiritual Well-Being, Personality and Individual Differences, 36(3): 629-643, 2004.
7) Atkinson M.J., Wishart P.M., Wasil B.I., Robinson J.W.: The Self-Perception and Relationships Tool (S-PRT): A Novel Approach to the Measurement of Subjective Health-Related Quality of Life, Health and Quality of Life Outcomes, 2: 2004.
8) Ledbetter M.F., Smith L.A., Vosler-Hunter W.L., Fischer J.D.: An Evaluation of the Research and Clinical Usefulness of the Spiritual Well-Being Scale, J. Psychol. Theol., 19: 49-55, 1991.
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