title: Religious and spiritual factors and the consequences of trauma: a review and model of the interrelationship.
abstract: OBJECTIVE
  An increasing body of literature examines the association of religious factors with posttraumatic stress as well as posttraumatic growth. This review of selected empirical studies describes religious and spiritual factors that have been examined in their association with the consequences of trauma. A comprehensive model is proposed to explain the complex interrelationship.
  
  
  METHODS
  We performed a qualitative review of empirical research in August 2006, updated in February 2008, using Medline (1950-present), PsychInfo (1806-present), Web of Science (1900-present), and PILOTS (1960-present). We searched the terms posttraumatic, posttraumatic stress, posttraumatic growth, and religion, religious, spirituality, spiritual, meditation, and forgiveness. Based on supporting data from reviewed literature, we then developed a model for key religious factors derived from this review predictive of the response to trauma over time.
  
  
  RESULTS
  Twenty-three studies were identified that describe religious pre-trauma characteristics, religious trauma-appraisal and post-trauma adjustment factors. The association of these factors with posttraumatic stress and growth is described.
  
  
  CONCLUSIONS
  Intrinsic religious orientation, in particular, appears to be a useful construct in measuring religiosity in the association with the consequences of trauma. There are preliminary indications that the association between intrinsic religiosity and the consequences of trauma may change depending on the time after the event. Future studies should stratify outcome by the time after trauma or use longitudinal designs.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA. Frauke.Schaefer@duke.edu
authors.forename: Frauke C
authors.initials: FC
authors.lastname: Schaefer
authors.forename: Dan G
authors.initials: DG
authors.lastname: Blazer
authors.forename: Harold G
authors.initials: HG
authors.lastname: Koenig
mesh_terms: D000223:Adaptation, Psychological; D006801:Humans; D008960:Models, Psychological; D012068:Religion and Medicine; D029181:Spirituality; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology* / Q000534:rehabilitation