Category: Spirituality and Religion

PS8- #C88 - Spirituality and Cognitive Fusion in Relation to Anxiety and Depression: When Is Spirituality Not Protective?

Saturday, Nov 18
8:30 AM – 9:30 AM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Spirituality and Religion | Cognitive Processes | Anxiety

Spirituality is an intricate part of the lives of many and has been a component of multiple psychological theories and treatments, including cognitive-behavioral therapy, (Stanley et.al, 2011). Research often demonstrates the protective effect of spirituality against negative mental health outcomes, including negative associations with anxiety (Bush et. al, 2012; Ramos et al., 2014) and depression (Bush et. al, 2012; Luna & MacMillian, 2015).  However, findings have not always been consistent, as several studies have reported null or positive associations between aspects of spirituality and anxiety and depression (Luna & MacMillian, 2015, Abu-Raiya et. al., 2015).  The variability in the literature suggests the need to identify potential moderator variables.  Under what conditions is spirituality associated with positive mental health outcomes and under what conditions is it not?

One potential moderator may be cognitive fusion (CF).  CF is a process by which individuals relate to thoughts as the literal truth and behavior is markedly influenced by these thinking (Hayes et al., 2012).  CF is a component of the psychological flexibility model of psychopathology and a treatment target in Acceptance and Commitment Therapy (ACT; Hayes et al., 2012). Research has shown CF is significantly related to psychological distress, including both anxiety and depression (Bardeen & Fergus, 2016).  With regards to spirituality, it may be that the protective effects of this construct against anxiety and depression weaken under contexts of high fusion.


The purpose of this study was to examine the association between spirituality, CF, anxiety, and depression. We hypothesized that spirituality would be negatively associated with both anxiety and depression, and relationship will be moderated by CF.  Specifically, we expected the link between spirituality and anxiety and depression outcomes would be strengthened under conditions of low to moderate amounts of CF, and attenuated under high CF.  


Two hundred and sixty-two participants were recruited using Amazon’s Mechanical Turk.  Participants were administered the Depression Anxiety Stress Scale (DASS; Lovibond & Lovibond, 1995), the Lindeman Spirituality Scale (LSS; Lindeman et. al., 2012), and the Cognitive Fusion Questionnaire (CFQ; Gillanders et. al., 2014). Multiple regression analyses were conducted preliminarily examine our hypotheses.  Supporting our hypothesis, the overall model explained 39% of the variance in anxiety, with the CFQ-LSS interaction explaining an additional 1% (p < .05).  In contrast, CF did not moderate the relationship between spirituality and depression.  Results will be discussed with regard to the interplay between CF and spirituality in understanding mental health outcomes.

Viktor Nowack

University of Baltimore
Baltimore, Maryland

John J. Donahue

University of Baltimore