The invisible battle: A descriptive study of religious/spiritual struggles in Veterans

The current study systematically explored and described religious/spiritual (r/s) struggles–distress, tension, and conflict about certain aspects of r/s belief, practice, or experience–in a Veteran sample. Participants were 178 United States Veterans (148 men, 30 women) receiving care at a VA hospital and affiliated outpatient clinics who reported a current r/s struggle. Veterans completed a psychiatric interview and self-report measures of demographics, military experience, and levels of religiousness. They completed self-report scales assessing levels of r/s struggle across different domains (i.e. divine, demonic, interpersonal, moral, doubt, ultimate meaning), provided open-ended descriptions of r/s struggles that were coded for these domains, and reported on a variety of characteristics related to their r/s struggle (e.g., duration, course, perceived cause, perceived impact on life, spiritual growth/decline resulting from the r/s struggle). Descriptive results from quantitative and qualitative data showed that Veterans perceived r/s struggles, particularly moral struggles, as salient and impactful. Veterans reported substantial positive effects and small negative effects of r/s struggles on their psychological and r/s functioning. Higher perceived negative effects were related to higher levels of r/s struggle domains. Statistical analyses comparing levels of r/s struggles and r/s struggle attributes across sample characteristics (e.g., demographics, psychiatric diagnosis, military experience) showed that, after controlling for religiousness, older age showed a positive association with positive perceived adaptation to r/s struggles, whereas the presence of a mental disorder and distressing military experiences showed associations with negative perceived adaptation. We discuss potential implications of these findings for research and clinical work.