title: The Greek-Orthodox version of the Brief Religious Coping (B-RCOPE) instrument: psychometric properties in three samples and associations with mental disorders, suicidality, illness perceptions, and quality of life.
abstract: BACKGROUND
  The B-RCOPE is a brief measure assessing religious coping. We aimed to assess the psychometric properties of its Greek version in people with and without long-term conditions (LTCs). Associations between religious coping and mental illness, suicidality, illness perceptions, and quality of life were also investigated.
  
  
  METHODS
  The B-RCOPE was administered to 351 patients with diabetes, chronic pulmonary obstructive disease (COPD), and rheumatic diseases attending either the emergency department (N= 74) or specialty clinics (N= 302) and 127 people without LTCs. Diagnosis of mental disorders was established by the MINI. Associations with depressive symptom severity (PHQ-9), suicidal risk (RASS), illness perceptions (B-IPQ), and health-related quality of life (WHOQOL-BREF) were also investigated.
  
  
  RESULTS
  The Greek version of B-RCOPE showed a coherent two-dimensional factor structure with remarkable stability across the three samples corresponding to the positive (PRC) and negative (NRC) religious coping dimensions. Cronbach's alphas were 0.91-0.96 and 0.77-0.92 for the PRC and NRC dimensions, respectively. Furthermore, NRC was associated with poorer mental health, greater depressive symptom severity and suicidality, and impaired HRQoL. In patients with LTCs, PRC correlated with lower perceived illness timeline, while NRC was associated with greater perceived illness consequences, lower perceived treatment control, greater illness concern, and lower illness comprehensibility.
  
  
  CONCLUSIONS
  These findings indicate that the Greek-Orthodox B-RCOPE version may reliably assess religious coping. In addition, negative religious coping (i.e., religious struggle) is associated with adverse illness perceptions, and thus may detrimentally impact adaptation to medical illness. These findings deserve replication in prospective studies.
authors.affiliation: Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Paika
authors.affiliation: Third Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Elias
authors.initials: E
authors.lastname: Andreoulakis
authors.affiliation: Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
authors.forename: Elisavet
authors.initials: E
authors.lastname: Ntountoulaki
authors.affiliation: Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
authors.forename: Dimitra
authors.initials: D
authors.lastname: Papaioannou
authors.affiliation: Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kotsis
authors.affiliation: Department of Speech and Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece.
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Siafaka
authors.affiliation: Third Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Konstantinos N
authors.initials: KN
authors.lastname: Fountoulakis
authors.affiliation: Department of Psychology, Bowling Green State University, Bowling Green, OH USA.
authors.forename: Kenneth I
authors.initials: KI
authors.lastname: Pargament
authors.affiliation: Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE Brazil.
authors.forename: Andre F
authors.initials: AF
authors.lastname: Carvalho
authors.affiliation: Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
authors.forename: Thomas
authors.identifier: 0000-0002-7647-4312
authors.initials: T
authors.lastname: Hyphantis
keywords: Anxiety; Chronic illness; Depression; Illness perceptions; Mental disorder; Psychometric properties; Quality of life; Religious coping; Religiousness; Suicidal risk