title: Spiritual coping and adjustment in adolescents with chronic illness: a 2-year prospective study.
abstract: OBJECTIVE
  Examine longitudinal relationships between spiritual coping and psychological adjustment among adolescents with chronic illness.
  
  
  METHODS
  Adolescents (N = 128; M = 14.7 years) with cystic fibrosis or diabetes completed measures of spiritual coping and adjustment at 2 time points ∼2 years apart; parents also reported on adolescent adjustment. Prospective relationships between spiritual coping and adjustment were evaluated with an autoregressive cross-lagged path model.
  
  
  RESULTS
  Positive spiritual coping predicted fewer symptoms of depression and less negative spiritual coping over time, whereas negative spiritual coping predicted more positive spiritual coping. Depressive symptoms predicted higher levels of negative spiritual coping and conduct problems over time. The results did not vary by disease.
  
  
  CONCLUSIONS
  Positive spiritual coping may buffer adolescent patients from developing depression and maladaptive coping strategies. Results also highlight the harmful role of depression in subsequent behavior difficulties and maladaptive coping. Addressing spiritual beliefs and depressive symptoms in pediatric medical care is warranted.
authors.affiliation: Department of Psychology, University of Alabama at Birmingham, Department of Pediatrics, Oregon Health and Science University, and Department of Pediatrics, University of Alabama at Birmingham.
authors.forename: Nina
authors.initials: N
authors.lastname: Reynolds
authors.affiliation: Department of Psychology, University of Alabama at Birmingham, Department of Pediatrics, Oregon Health and Science University, and Department of Pediatrics, University of Alabama at Birmingham.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Mrug
authors.affiliation: Department of Psychology, University of Alabama at Birmingham, Department of Pediatrics, Oregon Health and Science University, and Department of Pediatrics, University of Alabama at Birmingham.
authors.forename: Molly
authors.initials: M
authors.lastname: Hensler
authors.affiliation: Department of Psychology, University of Alabama at Birmingham, Department of Pediatrics, Oregon Health and Science University, and Department of Pediatrics, University of Alabama at Birmingham.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Guion
authors.affiliation: Department of Psychology, University of Alabama at Birmingham, Department of Pediatrics, Oregon Health and Science University, and Department of Pediatrics, University of Alabama at Birmingham.
authors.forename: Avi
authors.initials: A
authors.lastname: Madan-Swain
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D003550:Cystic Fibrosis / Q000523:psychology*; D003863:Depression / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D029181:Spirituality; D013315:Stress, Psychological / Q000523:psychology
keywords: adolescents; pediatric chronic illness; psychological adjustment; religious coping; spiritual coping